The medicalization of prostate cancer and the “test trafficking” of detection

2024-10-18 08:12:00

Him read a text about prostate cancerwhose medicalization is «test traffic» Tracking is currently a major health problem. Its author highlights the problems of testing and prostate cancer treatmentshighlighting that many doctors may be misinformed about its management.

Two relevant books are mentioned: Invasion of the Body Snatchers by Dr. Marco Scholz Yes The great prostate hoax From Riccardo Ablincriticizing the prostate-specific antigen test, known as PSA.

Annual PSA testing has led to an increase in unnecessary biopsies and surgeries, and Ablin warns that these tests “do more harm than good.” The analysis has 78% false positiveswhich can lead to harmful procedures.

Although he prostate cancer is often diagnosedIt is said that this type of malignant tumors progress slowly and most men do not die from it. A 15-year study indicates this only 3% of patients died from prostate cancerand the benefits of treatments such as surgery and radiotherapy are limited, reducing mortality by only 1-2% for low- and medium-risk cases.

Los risks associated with prostate surgery are significant, with a mortality of 0.17% and rates of urinary incontinence and impotence sexual as after-effects between 15% and 20%. For this reason, excessive treatment in urology is criticized.

In conclusion, the text highlights the need for a more cautious and informed approach in the diagnosis and treatment of prostate cancer to avoid unnecessary suffering.

Medicalized prostate cancer

The medicalization of prostate cancer has reached such an extreme level that there are many of them Doctors call for an end to early detection screening of the same. What does this test consist of? Prostate specific antigen or PSA is a protein produced by both normal and prostate cells. malignant (cancerous) cells. of the prostate. The test is used to measure the level of PSA in the blood. For this test, a blood sample is sent to a laboratory for analysis. Results are generally reported in nanograms of PSA per milliliter of blood (ng/ml).

Other scientific work that systematically evaluated evidence from randomized controlled trials to determine whether screening tests, for example mammography to detect breast cancer or PSA, reduce mortality due to diseases in which death is a common outcome.

And the conclusion is clear:

“Among currently available screening tests for diseases in which death is a common outcome, reductions in disease-specific mortality are rare, and reductions in all-cause mortality are very rare or nonexistent.”

THE Medicalization of prostate cancer and the abuse of PSA has been the subject of debate in the medical community and among medical experts. public health. Some specific data and relevant aspects on this topic:

1. PSA test: PSA is a protein produced by prostate cells and is used to detect high levels of this protein in the blood, which can indicate the presence of prostate cancer, but also it could be caused by other conditions.
2. Overdiagnosis: Many men with elevated PSA levels do not develop a life-threatening disease. It is estimated that up to 50% of men diagnosed with prostate cancer may have experienced no symptoms or complications. if the test had not been done.
3. Detection guides: Different organizations, like United States Preventive Services Task Force (USPSTF), have changed their recommendations regarding PSA testing. As early as 2012, the USPSTF recommended that older men not undergo regular PSA testing due to the risk of overdiagnosis and unnecessary treatment.
4. Treatment effects: Prostate cancer treatment may include surgery, radiation therapy, and hormone therapy, all of which may be necessary significant side effectssuch as erectile dysfunction, urinary incontinence and alterations in quality of life. In many cases, these effects can be avoided if cancer is not aggressive and does not require immediate treatment.
5. Mortality statistics: Despite the increase in prostate cancer diagnoses, mortality rates have decreased, in part due to increased awareness of the disease and advances in treatment. However, this also raises questions about effectiveness of early diagnosis in reducing mortality.
6. Personalized approach: A more personalized approach to the detection and treatment of prostate cancer is increasingly being advocated, assessing individual risk and assessing whether the benefits of testing and the treatments outweigh the risks.
7. Access to information: The increasing availability of information about prostate cancer and related tests has led to greater awareness and discussion between patients and doctors, which can influence the decision to undergo a PSA test.

Screening and clinical uncertainty

This phenomenon of medicalization and the excessive use of tests such as PSA highlight the importance of health education, access to accurate information and the collaborative approach between doctors and patients in making related decisions tests and treatments.

And that’s it Cancer screening has never been proven to “save lives”.

The oncologist Vinay Prasad and colleagues argue that reduction in overall mortality should be the benchmark and call for higher standards of evidence cancer screening.

Screenings – doctors explain Juan Gervas Yes Mercedes Perez Fernandez– are health interventions for the early diagnosis of asymptomatic diseases, involving people who believe they are healthy.

However, screening can only classify individuals as probably healthy or ill and requires subsequent diagnostic tests to identify true positives (sick) and false positives (probably healthy).

A significant problem in screening is overdiagnosiswhere conditions are diagnosed it would never evolve into a diseaseas in breast or prostate cancer, with high rates of overdiagnosis (up to 60% in the prostate). This can lead to unnecessary treatments and their side effects, without obvious benefits.

Furthermore, there is the classification of probably healthy which includes true negatives (really healthy) and false negatives (ill not detected). The progression of some diseases, such as some cancers, may be slow or regress spontaneously, which calls into question the justification of many screening programs. There is a lack of understanding regarding “natural evolution of the disease”.

Some clinical definitions, such as those of normality in screening tests osteoporosis or hypertensiontransform healthy individuals into patients, generating unjustified interventions and potentially harmful.

The conclusion of these health professionals is this all screening can cause harmand that it would be prudent to eliminate many of them, retaining only those that demonstrate a clear and verifiable benefit.