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Bury your head in the sand, if you wish but I prefer to know and face the enemy cancer, and not deny its potential to kill me.

I consider Dr. Brawley irresponsible, and the American Cancer Society an enormous disappointment for its fickle and outrageous abandonment of men with prostate cancer. I cannot help but note that ACS objected to the advice to women to quit breast cancer examinations until age 50 but acquiesced to the advice to men to quit testing altogether.Does ACS favor women's lives more than men's?
Phil O.

Rabbi Ed's Response:
As I stated in my blog post to which you've responded, I concur that avoiding PSA screening,- the only quasi-effective biomarker currently available, will leave us in the dark since most prostate cancers are symptom-free.

When I spoke about this last year by phone with Dr. Brawley, the ACS Chief Medical Officer, he was emphatic about the dangers of screening. In response I replied that men have a right and obligation to know what's going on in their bodies, and I added that ignorance is not bliss.

His response?: Screening makes sense only if men are fully informed of the risks and benefits of the various treatment options, and active surveillance is viable for those who want to be checked periodically and not risk more invasive treatment.

He has a point that each man has to decide for himself what's in his best interest, after consulting with his urologist and perhaps seeking some "natural" cures through supplements and vitamins. But since there is no scientific means to assure that an early-stage prostate tumor won't suddenly become more advanced, I myself agree with you that I would not want to avoid screening, nor would I agree to active surveillance for myself, which is why I chose robotic surgery.

Why not avoid the possiblity of overtreatment? Because like most men, I wouldn' t want to end up as a statistic among the minority of American men (3 percent=27,000) who die every year of prostate cancer, - the second leading cause of male cancer death.

For your information when he initiallly disavowed prsotate cancer screening in the media (October 2009), Dr. Brawley also publicly indicated that breast cancer screening was imprecise (false postives and negatives) and therefore not needed, but soon thereafter he retracted, indicating that he meant for those under age 40. It may be that breast cancer is a more complex disease than prostate cancer and requires immediate screening and treatment, but it may be that some political as well as medical considerations were at play in Dr. Brawley's retraction.
--Rabbi Ed

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