Posts Tagged ‘Prostate Cancer’

USPSTF Is At It Again

May 22, 2012

Today, as expected, the U.S. Preventive Services Task Force (USPSTF) released its report on the efficacy of PSA screening for prostate cancer with little change over the draft version released last fall. The USPSTF recommends against routine PSA screening of asymptomatic men no longer be screened for prostate cancer. The committee, that includes no one who deals with prostate cancer patients on a daily basis and is headed by a female pediatrician, cited statistics that more men die within a month of prostate cancer surgery than would have died from the disease. Given that 28,000 American men are expected to die from prostate cancer this year, it is hard to believe that a larger number would die within a month of prostate cancer surgery. Of course, surgery is only one of a number of treatments available for prostate cancer but the others are less likely to kill someone in the short run. I suspect that the comparison would be much different if the(infinitely small) death rates from other treatments were considered. The study also cited side effects, erectile dysfunction and incontinence, from prostate cancer surgery as a reason to avoid PSA screening. Again, some alternative treatments come with lower rates of these nasty side effects. I chose proton therapy for myself because it gave me the best chance of coming out of treatment whole.

The study ignores the benefits of building a history of PSAs for each patient. For example, researchers have found that rapidly increasing PSAs, more than 0.2 increase for two successive years, not only indicates a greater likelihood of having prostate cancer but a greater likelihood of having an aggressive type that needs to be treated soon. With no history of PSAs, many cancers that need to be treated promptly won’t.

African-American males, Vietnam veterans, and men whose relatives have had prostate cancer are all at higher risk of developing the disease. Not screening these groups (two of which apply to me) will surely increase the death rate from prostate cancer. The American Cancer Society’s annual report for 2012 shows that the death rate due to prostate cancer began declining when PSA screening started and continues to fall. This fact argues strongly against the USPSTF’s position that PSA screening doesn’t save lives.

Waiting until a men presents with symptoms of prostate cancer greatly increases the likelihood that he will die or suffer nasty side effects because the disease is generally greatly advanced before the patient becomes symptomatic. Something not discussed in the report is the high level of pain those who die of prostate cancer experience. For all its numerous faults, PSA testing is still the best available option. Fortunately, researchers are working to find better indicators.

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A Christmas Present from the VA

January 3, 2012

Disabled veterans got a Christmas present from the Veterans Administration in the form of a pay raise.  After receiving no increase the last two years, a 3.6% raise looks pretty good.  To put this in perspective, a 100% disabled veteran with a spouse and no dependent children or parents who was receiving $2,823 per month before the raise now receives $2,924 or $101 more.  It’s not a princely sum but it is better than we have been doing in recent years.  Because of the arcane way the VA assigns disability percentages, not everyone will get 3.4% more than they were getting.  In many cases, they will but others, with more complicated situations will get something a bit different.  Understanding the VA rate tables is essential to determining what one’s new compensation should be.  The VA rate tables can be found at: http://www.vba.va.gov/bln/21/Rates/comp01.htm

I think I may have figured out how the VA computes disability percentages for veterans with multiple disabilities.  It’s not simple.  If you have three disabilities– say a 60%, a 30% and a 10%–that total 10% under the normal rules of mathematics, you aren’t rated at 100% by the VA.  They determine disability percentages as being 100% minus an efficiency percentage.  If your first disability (in order of severity) is 60%, you are 40% efficient (100%-60%).  The second disability (30% in this case) leaves only 70% of the efficiency remaining after the first disability or 28% (40% times 70%).  The third disability (10%) leaves 90% of the efficiency remaining after the second disability was deducted or 25% (28% times 90%).  Subtracting the combined remaining efficiency from 100% yields 75% (100% minus 25%).  The VA rounds this percentage to the nearest 10% for a combined disability of 80%.  Eighty percent is a far cry from 100%, particularly the way the VA computes compensation.  An 8% disability does not get 80% of what a 100% disability gets.  For example, an 80% disabled vet with a spouse gets $1,602 per month, not $2,339 (80% of $2,924).  You can find the VA’s explanation of how they compute multiple disabilities at http://www.benefits.va.gov/warms/bookc.asp under section 4.25 Combined Ratings Table.

My Absence

October 7, 2011

Early in the summer, I announced that posts to this blog would be irregular for a time without stating a reason for the disruption. The reason for my absence was that I was spending the summer in Bloomington, Indiana receiving treatments for prostate cancer at the Indiana University Health Proton Center.  Choosing a treatment modality, proton therapy, that is not widely known was the result of extensive research. The research uncovered some things that were completely unexpected. The one that had the greatest impact was that I was probably exposed to Agent Orange while serving in Vietnam in 1967. Those who served in Vietnam during the time that Agent Orange was sprayed are eligible for disabilities and treatment from the Veterans Administration.  Unfortunately, the government does not put the same emphasis on informing veterans who were harmed while serving their country that it does soliciting “clients” for its welfare programs.

Knowing that I was far from being an isolated case, I decided to write a small book that veterans can use to help them navigate the VA and healthcare systems. My treatment for prostate cancer is complete and, after only seven months since first applying, my VA disability was approved. Prostate Cancer and the Veteran should make their process a bit easier than mine was.

This blog won’t be back to its old regularity just yet because, the day before my last treatment, I had a bicycle accident that fractured a vertebra. I’m far from being 100% yet and it appears it will take some time for that to happen. I do have a blog article underway. Carlisle Indians vs the Big Ten may surprise some people.

Hampton University Forges New Field — Again

April 11, 2011

When most people think of Hampton University, they consider it to be a historically black educational institution, which it is, of course. However, It is more than that. In 1878, Lt. Richard Henry Pratt convinced 17 of the younger of his former prisoners at Fort Marion, Florida to enroll in an educational program he established at what was then called Hampton Normal and Agricultural Institute. Pratt soon disagreed with Hampton’s policy of cloistering students from the community at large and proceeded to found Carlisle Indian Industrial School. Hampton did not stop educating Indians; it continued enrolling them for decades. Their records are a source of information for people researching Carlisle students as sometimes some family members attended Hampton while others attended Carlisle. Very few appear to have attended both schools. One person, and probably more, Angel deCora, the famous Winnebago artist, was first educated at Hampton and later taught at Carlisle.

Hampton University recently became the home of something else of interest to people living in the Mid-Atlantic Region. The Hampton University Proton Therapy Institute, the eighth such installation in the U. S. and the largest in the world, completed treatment of it first group of patients in November. These men were treated for Prostate Cancer but Proton Therapy is not limited to that application as it is also used to treat a variety of other types of cancer. Their web site states that Hampton Roads leads the country in Prostate Cancer deaths. That fact might be one of the reasons the $220M facility was located where it is. That the Department of Defense ponied up $7.9M toward its costs may be because so many military personnel are stationed in the Hampton Roads area or retire there. Large numbers of Viet Nam veterans are afflicted with Prostate and other cancers due to exposure to Agent Orange. Apparently, Agent Orange affected more than just the people who handled it in their daily work or those who trudged through the terrain that had been sprayed with the defoliant.

Proton Therapy appears to be the Prostate Cancer treatment modality with the fewest side effects of the available treatment options. Next time back to football, I think.