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Benign Prostate Hyperplasia

The prostate is a male reproductive gland that produces the fluid that carries sperm during ejaculation. It surrounds the urethra, the tube through which urine passes out of the body.

An enlarged prostate means the gland has grown bigger. Prostate enlargement happens to almost all men as they get older. As the gland grows, it can press on the urethra and cause urination and bladder problems.

An enlarged prostate is often called benign prostatic hyperplasia (BPH) or benign prostatic hypertrophy. It is not cancer, and it does not raise your risk for prostate cancer.

We have completed a study using natural supplements to prevent prostate enlargement.

The U. S. Preventive Services Task Force (USPSTF) has not reversed its non-recommendation of PSA testing despite the many voices raised in disagreement.
Doc Gumshoe weighted in on this topic back in May, 2013, and heres what I said then:

em>The Evidence Regarding PSA Testing and Prostate Cancer Treatment

First, lets look at the evidence marshaled by the USPSTF in their full report. The basis for their recommendation was that although screening based on PSA identifies additional prostate cancers, most trials found no statistically-significant effect on prostate cancer-specific mortality. The report cites two trials to answer the question whether PSA screening decreases prostate cancer mortality, both of these described as being of fair quality. One of these, conducted in the US, followed 76,693 men for 7 years and found no significant difference between men assigned to PSA screening and those assigned to usual care, meaning no screening. However, it turns out that of the men in the usual care group, 44% had had a PSA test before entering the trial, and 52% had a PSA test at some point during the trial. Thats what you would call a thoroughly tainted control group. So they were basically comparing men who were supposed to have had PSA tests with men who were not supposed to have PSA tests, but many or most of whom had PSA tests anyway.

The other trial, a multicenter European trial, found that PSA screening every 2 to 7 years was associated with a 20% relative risk reduction in a subgroup of 162,243 men aged 55 to 69 years.

Thats not nothing.

However, theres more. One of the participating centers, in Sweden, decided to publish their results separately. PSA screening every two years in a group of 20,000 men resulted in a decreased relative risk for prostate cancer mortality of 44% after 14 years of follow-up. Thats quite a lot more than nothing.

Since then, there is new information. A study using the U. S. National Cancer database found that one year after the USPSTF recommendation against routine PSA testing was issued in 2011, there was a large drop, 28%, in the diagnosis of prostate cancer, due without doubt to a decline in the number of men having PSA tests. The largest decline, 38%, was in the diagnosis of early, low-risk prostate cancer. But important declines were also found in the diagnosis of intermediate (28%) and high risk (23%) prostate cancers. These, by the way, are relative risk reductions the 23% decline would be from the number of men diagnosed with high risk prostate cancer prior to the USPSTF recommendation, and I do not have that number available, since the full study will not be published in the Journal of Urology until December.

Not diagnosing and treating! prostate cancer in those intermediate- and high-risk patients is tantamount, in my judgment, to condemning many of those men to an unnecessary and painful death.

And here are a few other data points from SEER: the five-year survival rate for men diagnosed with local and regional prostate cancer is close to 100%. But the five-year survival rate for men diagnosed with distant (i.e., high risk) prostate cancer is only 28.2%. Incidentally, the five-year survival rates for all forms of prostate cancer have increased dramatically since PSA testing was introduced in the mid 1980s from 66% in 1975 to 88.4% in 1990 to 99.7% in 2007.

Well see what happens if the USPSTF doesnt alter its recommendation. The lead author of the study, Dr Daniel Barocas, calls it throwing the baby out with the bathwater. I call it creating more work for the undertaker.

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