My name is Sal Banchitta- aka- Cousin Sal. I've had an incredible 30+ year career in the NY Fire Department, what so many of considered to be the best job in the world. There is no other profession that even comes close to the rewards of being a city firefighter. We were the first and last line of defense to protect this great city from any catastrophe and aligned with a special family of the most unique and remarkable men and women is truly the ultimate blessing.
PROSTATE SCAN NOW: I welcome you to view our pilot episode in support of proactive checkups and Prostate Health! I'm speaking to all my dude-friends in their 50's who need to start taking their health more seriously, while applauding those who have stayed on top of early detection and prevention. One such person is my latest hero in this- Mr. Barrie Kolstein. Check out our feature on this great motivator and role model!
STATS ABOUT PC:
"Prostate cancer is the second-leading cause of cancer death in American men, behind only lung cancer." (Source- American Cancer Assoc)
"...leading cause of cancer death among men in the US, with 94 men dying from it every day." (Source: pcf.org)
"More than 3.3 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today". (Source- American Cancer Assoc)
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This section originally published 8/26/20 @ The American Council on Science and Health (www.acsh.org) Patient-Specific Anxiety: "My PSA was 22. I had a biopsy; it was benign...GOOD! The biopsy showed inflammation, so I had a (surgical) biopsy I didn’t need... BAD! There has to be a better way!”
Evolution of NON-INVASIVE PROSTATE DIAGNOSIS
Prostate cancer, now considered the most common cancer in men, especially African-Americans (6-NIH), was rare until the 1950’s. Earlier, a blood test identifying prostate specific antigen (PSA was developed for use in “rape kits” to provide criminal evidence in court) was never designed as the screening tool for prostate cancer that it has become today. Our national guidelines recommend screening with PSA for men age 55 to 69, a recommendation that 40% of men follow. But what happens after a PSA test is termed positive?In 2012 the U.S. Preventive Services Task Force (USPSTF) recommended against routine PSA screening for prostate cancer due to the risk of over-diagnosis and over-treatment with most prostate cancer remaining asymptomatic. The panel concluded that the potential benefit of testing did not outweigh the risk of harm, arguing against continued screening except for those with known risk factors and a life expectancy greater than 10 years. Screening may have indeed reduced the rate of death from prostate cancer by an estimated 20%, but it was also associated with a high risk of overdiagnosis (diagnosis in men who would not have clinical symptoms in their lifetime). This means that PSA testing would have saved about 60,000 lives but some 900,000 men would have undergone the undue injury of an unnecessary surgical biopsy.
THE BIOPSY is an invasive procedure removing a small section of tissue and examination for cancer cells. It remains the gold standard in diagnosing prostate cancer. Biopsies are now performed in an office setting, using topical or sedation anesthesia. It involves using a needle to obtain tissue from the prostate through the rectum. Twenty five years ago the routine biopsy protocol called for six needle cores. Because it was performed without imaging, it missed many cancers deep within the prostate. The number of tissue samples taken was expanded to 12 and even up to 96 cores at some centers. Needle biopsies cause serious complications in 1% of patients - even fatal outcomes have recorded. Infection which can require prolonged antibiotic therapy is the most common problem. Nowadays biopsies are guided, meaning that doctors use imaging through ultrasound or MRI to direct the needles to areas of concern.
CALLING FOR A DIAGNOSTIC UPGRADE: The strategy of relying on a (PSA) blood test as the precursor to a biopsy required significant reassessment. Though approved by the FDA in 1986 as the gold standard for monitoring cancer relapses, increasing reports continue to indicate that elevated PSA levels in over 70% of men show a false positive reading- and does not conclude a malignant cancer. (NIH ref). Because of the inaccuracies of the PSA test and the risk of side effects, many centers are now using imaging solutions like ultrasound 3-D Doppler and MRI before considering a biopsy.