08 October 2011

When Will Dr Muskett Write A Column On Prostate Cancer Screening?

Dr Alan Muskett, erstwhile cardiac surgeon right here in River City, and nowadays professing plastic surgery at the same general location, has treated us Montanans to a useful summary of the problems of MMI, or Male Mid-Life Insanity, and he has likened healthcare to a restaurant buffet, and a host of other useful articles to enable us commoners to get through the menu of everyday medical and surgical care, almost always with a smile on our face.

Now we are wondering when he will give us the straight scoop on screening for prostate cancer. We remember that they told us that we could dispense with PSA testing when we reached the age of 75 or so. Now the Associated Press in today's Gazette has revealed to us old guys who are finally persuaded to get regular PSA tests done, that we shouldn't do that at any age. What is going on here? First of all, many of us don't trust the AP so maybe this would be a good time for Dr Muskett, or perhaps one of his friends of the urologic persuasion, to reassure us.

This would be a delicate operation because there are a fair number of older and some relatively young men who have had radical prostatectomies based in part on PSA levels. Telling their cousins and friends that they don't need to be screened risks the wrath of those who have had the operation, especially if they have had complications such as impotence and incontinence. And for those who like to have complete explanations for drastic changes in tactics or strategy, there are problems when we have to admit that some of the things we call cancer won't kill you if left alone, that even a normal PSA doesn't guarantee that you are free of prostate cancer, and that even our best surgeons are sometimes wondering what to do. This will not be good for the doctor-patient relationship.

I just asked Johns Hopkins to send me a free special report on my prostate biopsy. More on that later.

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