* I was right - as this guy notes, The Count of Monte Cristo has, for some odd reason, had a resurgence of online approval and discussion in recent months. Not entirely sure I should read it, all the same, given my better understanding of its nature from the video.
* I now also understand more about The Odyssey, from this other guy's video. I see Mary Beard has put out one about it, too. She's hoping she can like Christopher Nolan's movie, but we shall see. (I haven't watched the video fully yet, though.)
* This is possibly the most dramatic earthquake video I have ever seen. Poor people.
* Away from Youtube, the never ending uncertainty about how to deal with prostate cancer risk continues:
A growing number of prostate cancer experts argue that calling the lowest-risk prostate cancer "cancer" does more harm than good. A new UCLA-led study found removing the cancer label could dramatically reduce overtreatment and encourage more men to get screened, potentially leading to significantly fewer deaths from aggressive prostate cancer.
Using a model based on U.S. population data, the researchers estimated that relabeling Grade Group 1 (GG1) prostate cancer—the earliest and lowest-risk form of the disease—as a precancerous condition could reduce unnecessary treatment and prevent nearly 2,400 prostate cancer deaths annually. The researchers found this benefit would largely come from more men choosing PSA screening, as relabeling GG1 could reduce concerns about overdiagnosis and unnecessary treatment among patients and clinicians.
A large body of research has shown that a pure GG1 cannot cause symptoms or metastasize. Guidelines therefore recommend active surveillance (including PSA testing, MRI and periodic biopsies) rather than treatment for nearly all men diagnosed with GG1. Nevertheless, up to 40% of men in the United States with GG1 continue to get treatment....Unlike aggressive prostate cancers that can spread throughout the body, GG1 prostate cancer, also known as Gleason 6 prostate cancer, typically grows slowly over years or decades, or not at all. These tumors do not cause symptoms or become life-threatening unless a higher-grade cancer develops in the prostate.
But the diagnosis itself can be difficult for patients to process.
Research has shown that men diagnosed with GG1 typically experience stress and anxiety, and many choose surgery or radiation even when active surveillance would be the most appropriate option. Those treatments can cause long-term complications, including urinary, bowel and sexual dysfunction. In addition, patients unnecessarily lose access to life insurance because of the cancer diagnosis.
The authors also note that calling these tumors "cancer" contributes to overtreatment because patients may assume the disease is more dangerous than it is.
2 comments:
I read something on this a few weeks ago. Another recent study argues low risk should be monitored not treated. Biopsies carry risks and PSA can be very misleading.
AI search
Men with low‑risk prostate cancer increasingly opt for active surveillance rather than immediate treatment.
The study (published June 23, 2022) found no higher risk of cancer recurrence among men who were monitored rather than treated right away.
This supports the idea that overtreatment is common and that many low‑risk cancers may never become dangerous.
This aligns with a broader shift in prostate cancer care: treatment is not always better, especially for cancers unlikely to progress.
The underlying issue from my perspective is that unlike colon cancer screening, breast cancer screening and cervical cancer screening, prostate screening was never properly studied before it was unleashed.
Because you are taking asymptomatic people and subjecting them to a potentially hazardous procedure the onus is on the profession to ensure that the risk benefit ratio is heavily in the benefit side.
No such studies were done, it was just considered obvious that since prostate cancer sufferers had high PSA, that elevated PSA meant you had a cancer worth treating.
This meant many men were overtreated but told they had been cured and became supporters of more screening.
Urologist have calmed down recently and are avoiding biopsies where they can and relying on MRI and watchful waiting more.
I agree that it is hard for patients to be told they have cancer but we aren't doing anything about it. It takes a lot of explanation to calm the patient down and for them to be comfortable with the approach.
BTW I recall that when I was working for Veteran's Affairs in the 1990s they sponsored research that came to much the same conclusions way back then.
Geoff
Post a Comment