In 1973, we urologists had prostate cancer about right, no screening, no radiation, and no radical surgery. All cancers discovered were assumed to be metastatic from the get-go. If any treatment was necessary, it was systemic hormone deprivation. But, ten years later (1983 - 1987) radical surgery was revived without new evidence; ultrasound probes were miniaturized to fit in the rectum; and the PSA blood test was described as capable of finding new cancers but as lacking the specificity required for screening. The whole ...
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In 1973, we urologists had prostate cancer about right, no screening, no radiation, and no radical surgery. All cancers discovered were assumed to be metastatic from the get-go. If any treatment was necessary, it was systemic hormone deprivation. But, ten years later (1983 - 1987) radical surgery was revived without new evidence; ultrasound probes were miniaturized to fit in the rectum; and the PSA blood test was described as capable of finding new cancers but as lacking the specificity required for screening. The whole world screened anyway. Money poured into U.S. hospitals and faculty practice plans. Post-radical surgery deaths (2600) peaked in 1992. By the autumn of 2011, two reports had showed that radical surgery did not lengthen cancer specific life compared to nothing. PSA screening was found by the Preventive Task Force of the U.S. Federal government to cause more harm than good. This book reinforces their statement,
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