Archive for the ‘Medical News’ Category

Prostate cancer screening

Wednesday, September 22nd, 2010

Prostate cancer screening remains highly controversial.  The only blood test, the PSA, is perhaps the most inaccurate test that I order.  Part of the problem is that PSA is made by normal prostate glands and it goes up gradually in men with age.  Individuals with prostate cancer may have a higher PSA, but even that is not always true.  A normal PSA level does not rule out cancer, nor does a mildly high PSA rule it in.  Added to this inaccuracy is the uncertainty towards the value of treatment nor which treatment is clearly superior.  Finally, most men who get prostate cancer will not die from that disease so the value for screening is more questionable particularly as one gets older with other medical problems becoming more common.

Two recent studies now suggest that a single PSA test (rather than annually) may be enough of a screen if the result is solidly normal (less than 2, normal usually up to 3.5 to 4).  The most recent study included 86,000 men between ages 55 to 74 and followed for 9 years.  Close to 70% of men had low PSA baseline numbers of less than 2 and for that majority there was no benefits for continued screening as related to death from prostate cancer.  A similar conclusion was made in another large study published in the British Medical Journal.

Unfortunately, this will probably not change the physician community behavior anytime soon where annual PSA tests are done frequently often leading to more tests and invasive procedures.   More and more information however is suggesting this needs to change.

Flu shot

Wednesday, September 22nd, 2010

Yes, it is that time again! The office has the flu shots available either during a visit, or just by dropping in at the office. For those not needing to be seen, flu shots are done Tuesday, Wednesday or Thursday in the morning (9 to 11) or afternoon (2 to 4) and you do not need to call in advance. Ideally flu shots should be done soon, but certainly by the end of November or December at the latest.

H1N1

Wednesday, September 30th, 2009

Of course just after my last post I would hear on the national news (and by forwarded email) of a young healthy teenager who tragically died from the H1N1 virus.  As disturbing and gut-wrenching such stories always are, it is also disturbing to me how the media portrays the event.

The story does include comments on how this is very rare, that most cases of these illnesses will be self-limiting and mild to moderate, but that is only briefly mentioned.  As presented, it will increase fear and demands for stock piling of anti-viral medicines like Tamiflu (that have minor effects on the illness at best) and demands for the vaccine from many who have lower risks.

Tens of thousands of deaths will happen each year from the regular strain of influenza, and many others from other infections.  It makes little sense to fixate on this one more than the others, or the 40 thousands deaths each year from car accidents or those who pass away from cardiovascular troubles from heart attacks to strokes.  While H1N1 deserves our attention, it’s important to stay focused on the big picture and overall risks and take care of things that we can influence with healthy lifestyle and common sense.