Federal Panel Rejects Prostate Cancer Screening

You may be asking yourself the question as to why a government panel would reject a prostate screening test that could save a life.  This news is getting posted on many medical websites.
The panel decided that the harm of the screening test outweighs the benefit for preventing prostate cancer.
The following is an article from a Boston publication.

The US Preventive Services Task Force determined that based on evidence from two large randomized trials, the lifesaving benefits of screening were “at best very small” and were offset by overdiagnosis and overtreatment of non-lethal cancers.

.“Our most optimistic estimate is that 1 out of 1,000 men screened will avoid dying from prostate cancer” because of early detection via the PSA test, said Dr. Michael LeFevre, co-vice chair of the task force. “We’re not saying it’s zero. We’re leaving the window open for at least a small benefit.”

“It’s hard to understand where they’re coming from,” said Dr. Anthony D’Amico, chief of genitourinary radiation oncology at Brigham and Women’s Hospital, in an interview.

D’Amico argued that the task force relied too heavily on data from a flawed study and failed to consider making separate recommendations for men in high-risk groups, such as those with a family history of prostate cancer and African Americans, who have a two to three times greater risk of dying of the cancer than white men. 

The task force, which is comprised of 16 primary care physicians and public health experts with no financial interests in tests or treatments, issues screening and other preventive health recommendations that tend to be more conservative than those of medical societies -- composed mostly of specialists who treat diseases detected through screening -- or patient advocacy groups.

Former New England Patriots player Mike Haynes, a paid spokesperson for the urological association, said in an interview that he was diagnosed with prostate cancer in 2008, at age 55, after getting a free screening PSA test at an NFL event for retired players, sponsored by the urological association. He said he wasn’t told about any of the risks of the tests such as false positive results, unnecessary biopsies, and overtreatment of slow-growing cancers. His elevated PSA and subsequent biopsy revealed a stage 1, slow-growing cancer, and he said, “one of my options was watchful waiting, but my immediate reaction was let’s get it out of my system.” 

He considers himself lucky, however, in that the only side effect he had from his surgery was a few months of urinary incontinence that has since resolved.

To read the complete article : http://www.boston.com/dailydose/2012/05/21/psa-screening-for-prostate-cancer-gets-thumbs-down-from-federal-panel/ip80Gu1FRujF8B7mTGfNEJ/story.html

What do you think of the the panel's decision?

Good Explanation of Triple Negative Breast Cancer

A wonderful explanation for us to understand 'triple negative breast cancer' is found at breastcancer.org.

To understand triple-negative breast cancer, it’s important to understand receptors, which are proteins found inside and on the surface of cells. These receptor proteins are the “eyes” and “ears” of the cells, receiving messages from substances in the bloodstream and then telling the cells what to do.

• Hormone receptors inside and on the surface of healthy breast cells receive messages from the hormones estrogen and progesterone. The hormones attach to the receptors and provide instructions that help the cells continue to grow and function well. Most, but not all, breast cancer cells also have these hormone receptors. Roughly 2 out of 3 women have breast cancer that tests positive for hormone receptors. (For a more complete explanation, see the previous section on Hormone Receptor Status.)
• A smaller percentage of breast cancers — about 20-30% — have too many HER2 receptors. In normal, healthy breast cells, HER2 receptors receive signals that stimulate their growth. With too many HER2 receptors, however, breast cancer cells grow and divide too quickly. (For a more complete explanation, see the previous section on HER2 Status.)

Hormonal therapies and HER2-targeted therapies work to interfere with the effects of hormones and HER2 on breast cancer, which can help slow or even stop the growth of breast cancer cells.

About 10-20% of breast cancers test negative for both hormone receptors and HER2 in the lab, which means they are triple-negative. Since hormones are not supporting its growth, the cancer is unlikely to respond to hormonal therapies, including tamoxifen, Arimidex (chemical name: anastrozole), Aromasin (chemical name: exemestane), Femara (chemical name: letrozole), and Faslodex (chemical name: fulvestrant). Triple-negative breast cancer also is unlikely to respond to medications that target HER2, such as Herceptin (chemical name: trastuzumab) or Tykerb (chemical name: lapatinib)

 

                                        The Biology of Triple Negative Breast Cancer

                                        In addition, triple-negative breast cancer

     Tends to be more aggressive than other types of breast cancer. Studies have shown that triple-negative breast cancer is more likely to spread beyond the breast and more likely to recur (come back) after treatment. These risks appear to be greatest in the first few years after treatment. For example, a study of more than 1,600 women in Canada published in 2007 found that women with triple-negative breast cancer were at higher risk of having the cancer recur outside the breast — but only for the first 3 years. Other studies have reached similar conclusions. As years go by, the risks of the triple-negative breast cancer recurring become similar to those risk levels for other types of breast cancer. 

• Tends to be higher grade than other types of breast cancer. The higher the grade, the less the cancer cells resemble normal, healthy breast cells in their appearance and growth patterns. On a scale of 1 to 3, triple-negative breast cancer often is grade 3.
• Usually is a cell type called “basal-like.” “Basal-like” means that the cells resemble the basal cells that line the breast ducts. This is a new subtype of breast cancer that researchers have identified using gene analysis technology. Like other types of breast cancer, basal-like cancers can be linked to family history, or they can happen without any apparent family link. Basal-like cancers tend to be more aggressive, higher grade cancers — just like triple-negative breast cancers. It’s believed that most triple-negative breast cancers are of the basal-like cell type.
• http://www.breastcancer.org/symptoms/diagnosis/trip_neg/behavior.jsp