1. Your comment is not exactly accurate.

I believe you are referring to autopsy series, or prostates that are looked at after someone dies.

The number in patients in their 70s is very high, although not quite as high as 80% I do not believe.

The number of men in that have prostate cancer on biopsy is much less than that.

As a urologist specializing in prostate cancer, I deal with this every day.

We are currently relying on PSA and rectal exams to see who needs a prostate biopsy. Men with a 10 year life expectancy should be counselled and offered a PSA blood test.

I applaud the cancer blog for getting important information to the public.

I am blogging at the robotic surgery blog.
www.RoboticSurgeryBlog.com

Posted at 5:16PM on Mar 10th 2007 by Domenico Savatta, M.D.

2. Screening tests may pick up minute tumors that would not progress and might even go away if left alone (pseudodisease). Pseudodisease is most common in prostate and breast cancer, and is an issue in lung cancer. Patients may become alarmed and exposed, perhaps needlessly. There are microscopic cancers that will never cause us problems.

When cancer is looked for early, a wide net is cast for both real and pseudodisease. Since we can't tell which is which, we treat it all. Thank goodness for diagnostic tests like Oncotype DX and MammaPrint for breast cancer and hopefully the Lung Metagene Predictor for lung cancer.

According to some clinical scientists, it is said that approximately 3% of men will actually die from prostate cancer (generally at a fairly advanced age). But pathology studies show that at least half of all men in their 60's have microscopic evidence of prostate cancer. Most men probably do as they age. If we look hard enough, we will find it.

Different pathologists looking at the same cells can reach different conclusions about who has cancer. This has been shown in prostate cancer, breast cancer and melanoma. There is no way to know who is right. Pathologists can readily distinguish between big invasive cancers and normal tissue, but they disagree about what to call cancer in a large gray area in between.

Posted at 1:02PM on Apr 8th 2007 by Gregory D. Pawelski