Scott Adams: Dilbert And Prostate Cancer - Page 1
Forum section: electronics / general

author: EEVblog
author_rank: Unknown
timestamp: May 20, 2025, 12:25:38 am
content: Very sad to hear that Dilbert creator Scott Adams has cancer and probably only months to live.https://x.com/NJBeisner/status/1924508242744639566It's in the latest live stream, but I have not watched it all yet:

author: brucehoult
author_rank: Super Contributor
timestamp: May 20, 2025, 12:27:55 am
content: In the same week as Biden? What are the chances?

author: MK14
author_rank: Super Contributor
timestamp: May 20, 2025, 12:47:46 am
content: Quote from: brucehoult on May 20, 2025, 12:27:55 amThe news article(s), seems to imply that Scott Adams, on hearing Biden's news, decided to tell people about his news. Essentially around a day later.

author: EEVblog
author_rank: Unknown
timestamp: May 20, 2025, 01:13:52 am
content: Quote from: MK14 on May 20, 2025, 12:47:46 amYes, he decided to reveal it now so that he wouldn't get as much hate, while all the hate is focused on Biden.He's had it for years. Those that have watched his live shows regularly knew that something was up, and many had guessed.

author: UnijunctionTransistor
author_rank: Frequent Contributor
timestamp: May 20, 2025, 01:32:21 am
content: Correct.I have had a pair of relatives and some friends perish from cancer.They all attempted to conceal it as best they could, but one could see something, don’t know how to describe it better, than the look of a dying person.

author: EEVblog
author_rank: Unknown
timestamp: May 20, 2025, 01:44:58 am
content: Quote from: UnijunctionTransistor on May 20, 2025, 01:32:21 amDon't know what I'd do, but my guess would be hide it too.Haven't been tested for PSA in 2 years because the government decided that 12 months testing was too frequent, so it's now every 2 years, due again now though. I've been under 1 for the last three tests (normal PSA range 0.30 to 3.50 ug/L)https://www.clinicallabs.com.au/about-us/doctor-media-releases/new-mbs-items-for-psa-tests/I did have a bit of a prostate scare late last year, it suddenly really hurt to urinate. Never had that before in my life. Went for an ultrasound but everything was normal, apparently just a temporary inflammation which I was told is common and nothing to worry about. Better after a few days.This makes me want to pay for a yearly test regardless. Doctor said I couldn't even pay for the extra test as it was under Medicare. I'd have to go get a private test done somewhere.

author: CatalinaWOW
author_rank: Super Contributor
timestamp: May 20, 2025, 03:13:10 am
content: Quote from: EEVblog on May 20, 2025, 01:44:58 amThe stiff upper lip stuff has its place, but there are things that others can help with.I have had prostate cancer, and have been cured, no more signs of the cancer. Which is the most common outcome for that cancer as it is usually caught before the stage Biden had. It is curious that someone with the annual exams and extreme care that the US president gets somehow got that far without detection.I was close mouthed about my situation, and in retrospect wish I had been more open. I rushed into treatment, didn't fully understand all the options and their consequences. If I had discussed my case, particularly with people who had been through it before I might well have chosen the same treatment path, but I definitely would have reduced my surprise and anxiety as I encountered the reality.As an aside, the Aussie test schedule is far more liberal than the US schedule, and even the US schedule seems to catch the vast majority while they are still treatable. Caught mine, even though I was testing lest frequently than authorized. I wouldn't worry too much about it.

author: EEVblog
author_rank: Unknown
timestamp: May 20, 2025, 04:02:50 am
content: Quote from: CatalinaWOW on May 20, 2025, 03:13:10 amI'd rather pay money every year anddefinitelynot have to worry about it.

author: Bud
author_rank: Super Contributor
timestamp: May 20, 2025, 04:47:29 am
content: Quote from: CatalinaWOW on May 20, 2025, 03:13:10 amBlood PSA test is not much indicative. Too much range. Biopsy (sampling the actual tissue) is more accurate but painful I heard.

author: Siwastaja
author_rank: Super Contributor
timestamp: May 20, 2025, 05:24:45 am
content: Quote from: EEVblog on May 20, 2025, 04:02:50 amThe story here goes it has so high rate of false positives that the detrimental health effect from the added worry is worse than the disease itself, but I don't know, maybe it's just an excuse why tests are not being done on public healthcare here

author: EEVblog
author_rank: Unknown
timestamp: May 20, 2025, 05:49:52 am
content: Quote from: Bud on May 20, 2025, 04:47:29 amThe PSA test is designed to indicate if there might potentially be a problem, it's not an actually quantitative test for prostate cancer.It's not like the doctor measures your PSA and it's off the charts and then tells you it's all over and get your affairs in order. It's a trigger to then go see specialist.Grok says a false negative PSA is roughly 10-20% likely.This is why you get tested periodically so you can track any changes.Common Causes of False Positives:- Benign Prostatic Hyperplasia (BPH): Enlarged prostate, common in older men, often raises PSA.- Prostatitis: Inflammation or infection of the prostate can significantly elevate PSA.-Recent Sexual Activity or Prostate Manipulation: Ejaculation, vigorous bike riding, or a digital rectal exam can temporarily increase PSA.- Age and Lifestyle: PSA naturally rises with age, and certain medications or infections can also affect levels.

author: EEVblog
author_rank: Unknown
timestamp: May 20, 2025, 05:56:56 am
content: Quote from: Siwastaja on May 20, 2025, 05:24:45 amAssume the latter.

author: RJSV
author_rank: Super Contributor
timestamp: May 20, 2025, 06:00:57 am
content: Is not this guy, Adams, himself now the target of hate speech ?(That's one of those 'rectorial questions', that aren't needing a real answer).

author: NE666
author_rank: Frequent Contributor
timestamp: May 20, 2025, 08:19:54 am
content: Quote from: RJSV on May 20, 2025, 06:00:57 amAre you referring to the clergy, or are we back on digital rectal exams?

author: tggzzz
author_rank: Super Contributor
timestamp: May 20, 2025, 08:42:25 am
content: Quote from: EEVblog on May 20, 2025, 05:49:52 amI'd ignore LLM hallucinations until the source has been found and assessed.The UK's NICE (National Institute for Clinical and Care Excellence) publishes definitive guidelines on this and other medical matters. Some publications are for the intelligent layman, some are for healthcare professionals ("cks" in the URL). The former areveryinformative, the latter often require clinical training but can indicate understandable information, e.g. how long a drug remains active in the body.The guidelines are regularly updated, and indicate the rationale for the recommendations, explicitly including probabilities.Hence:https://www.nice.org.uk/guidance/ng131which will be irregularly updatedhttps://www.nice.org.uk/guidance/ng131/resources/prostate-cancer-diagnosis-and-management-pdf-66141714312133https://cks.nice.org.uk/topics/prostate-cancer/and especially:https://cks.nice.org.uk/topics/prostate-cancer/diagnosis/assessment and screeninghttps://cks.nice.org.uk/topics/prostate-cancer/management/which indicate why, currently, "PSA testing should not be offered to asymptomatic people"

author: tggzzz
author_rank: Super Contributor
timestamp: May 20, 2025, 08:43:30 am
content: Quote from: EEVblog on May 20, 2025, 05:56:56 amFalse assumption. See the NICE guidelines (q.v.) for the reasons.

author: PlainName
author_rank: Super Contributor
timestamp: May 20, 2025, 08:48:35 am
content: Quote from: EEVblog on May 20, 2025, 05:56:56 amThere was some talk around here that the better testing was throwing up cases that otherwise wouldn't have been noticed, and causing operations (with potentially serious side effects) to be undertaken. Previously, these cases would have died from other causes (like old age) before the cancer got them (or even became known), so the better testing is something of a mixed bag.

author: tggzzz
author_rank: Super Contributor
timestamp: May 20, 2025, 08:57:41 am
content: Quote from: PlainName on May 20, 2025, 08:48:35 amOver-treatment was definitely a problem, certainly in the US and to a lesser extent in the UK. Nowadays there is much more understanding of when someone is likely to diewithPCa rather thanfromPCa. Good.Allof the treatments can havesignificantside effects. I chose my treatment based on what side effects I wanted to avoid. Other people will make different decisions. In the US there is the tendency to over treat to (1) get money and (2) avoid "why didn't you treat my dead relative" lawsuits.

author: EEVblog
author_rank: Unknown
timestamp: May 20, 2025, 10:02:09 am
content: Quote from: PlainName on May 20, 2025, 08:48:35 amSo... don't test?You do you, I'm getting my test every year.

author: tggzzz
author_rank: Super Contributor
timestamp: May 20, 2025, 10:49:29 am
content: Quote from: EEVblog on May 20, 2025, 10:02:09 amBased onmodernunderstanding, don't do PSAscreeningtests if you are asymptomatic. If you have a symptom that might be prostate related, then do test.As NICE - who really do know the subject - put it "The prostate-specific antigen (PSA) test is not appropriate as a screening tool as it is neither sensitive nor specific for this purpose. It would generate too many false positives and false negatives. Resulting in potential unnecessary and invasive tests and/or unnecessary treatment."Don't forget that invasive tests carry a non-zero risk of harming the patient. You have to weigh up the probability ofharm by missing a cancerthat would be cured(an important post condition)harm during a procedure where there is no cancerWith both PSA tests and mammograms,those probabilities are too similar for comfort.Here's the stats for mammograms. I'd like to see the same for PSA tests; everything I've read (and I've read a lot) indicates the PSA/PCa tests are worse in this respect. my surgeon wasoneof the people who formulated an earlier version of the guidelines. They know their stuff; I trust themmuchmore than random comments on the web I had a conversation with a consultant along the lines of C:"the followup test results are X". Me: "so that means the grading is Y". C: "exactly, and at this point you know more than most GPs".

author: SteveThackery
author_rank: Super Contributor
timestamp: May 20, 2025, 11:17:55 am
content: Quote from: tggzzz on May 20, 2025, 10:49:29 amWell, that didn’t work for me. I went to the GP for a bowel issue which turned out to be nothing at all, but which required a digital rectal exam. The GP noticed a hardening on one side of the prostate, but no enlargement. I mentioned that I had never had a PSA test (I am 67), nor any reason to because I was entirely free of any symptoms.The result came back as 51, so I got whisked off for a PET scan. It is Stage 4 terminal prostate cancer which has spread through the lymph nodes up to the level of the kidneys. Gleason score is 9 out of 10. It is incurable. I remain completely symptom-free.It was a remarkable experience: one day I was completely fine, the next day I had terminal cancer. Hell of a blow.So Dave, I am 200% behind you: get yourself that PSA test every year.And yes, I know I am just one data point and policy cannot be decided like that. But I think this is one area where policy does not align with the interests of the individual, and as we are all individuals, the latter must come first.PS: the hormone treatment brought down my PSA a lot. The chemotherapy reduced the inflammation in the lymph nodes, and I'm now having radiotherapy on the gland itself. The oncologist says the turning point will be when the cancer adapts to the hormone treatment - which it always does, it's just a matter of time. After that it will be downhill all the way.So, my entirely irrational take on the situation is this: fuck government policy, and fuck the statistics; get yourself that PSA test NOW, and get one every year forever.

author: Pinkus
author_rank: Frequent Contributor
timestamp: May 20, 2025, 11:28:02 am
content: As it is important to see the progression of the PSA value (which generally increases with increasing age) over long term (to be able to detect a sudden increase at an early stage), you should in fact have your PSA value determined annually (for values below 1, every 2 years is sufficient).

author: tggzzz
author_rank: Super Contributor
timestamp: May 20, 2025, 11:32:09 am
content: Quote from: SteveThackery on May 20, 2025, 11:17:55 amVery similar for me. PSA test after a DRE, result 24. I had previously been offered PSA screening, but knowing the poor specificity and bad side effects of treatment, I had declined. I don't regret that decision.Given how slowly it progresses, I took several months researching the topic, and finally chose treatment based on the least unacceptable side-effects.I still have PCa (i.e. biochemical reoccurrence PSA != 0), but expect to die with it, rather than from it.Conclusion: faites vos jeuxmesdames etmessieurs.

author: tggzzz
author_rank: Super Contributor
timestamp: May 20, 2025, 11:41:00 am
content: Quote from: SteveThackery on May 20, 2025, 11:17:55 am"The race is not always won by the fastest horse, but that's the way to bet".The UK policy is rationally based on hard demonstrable statistics - as it should be. Some individual cases won't conform to the stats, as you say.Each individual has a different attitude to risk, reward, punishment. That should be taken into account.Any statements about global applicability indicate the person making the statement has insufficient understanding. Such statements are all too common

author: jpanhalt
author_rank: Super Contributor
timestamp: May 20, 2025, 12:13:17 pm
content: Sorry to be late. My thoughts on PSA:1) It's a useful screening test, and it should be done annually in all men over a certain age (45 to 50). One does not look just for a really high value, but rather a rising value. Be aware that at low levels and with different labs there will be variation. Variations at levels < 1.0 to 2.0 ng/ml at likely normal variation. Of course, a high value (>4 ng/ml depending on the lab) would an indication for a repeat test or other tests.2) A lab will report its normal values (aka reference ranges). The lab my PSA goes to has 4 ng/ml as its upper limit. I would be concerned if my value, which has been <<1.0 for years got above 2.0. That would not mean I would head to surgery or needle biopsy immediately.3) The rate of clinically benign prostate carcinoma increases with age. Some pathologists believe at age 70, 50% or more men will have evidence of some malignancy on autopsy studies. That is, where the entire prostate can be examined. Grok3 puts the prevalence lower.* Don't confuse incidence data with prevalence.4) Needle biopsy sounds bad, but those who have had it report generally it is not so bad.5) The risk of surgical resection goes up with age. In young men, whether to have surgery is rarely a question. In older men, one has to consider the risk of surgery and convalescence versus no surgery. At President Biden's age, I would not risk surgery for myself, unless it was just palliative. I have already discussed this matter with my PCP (primary care physician in US speak) and we have agreed.Bottom line: If you are over 50 get a PSA.*Grok3: "Autopsy (Latent) Prevalence: Studies on autopsies show a much higher prevalence of undetected (latent) prostate cancer. By age 70, approximately 30-50% of men may have histological evidence of prostate cancer, meaning small, often non-aggressive tumors are present but not necessarily diagnosed during life."

author: SteveThackery
author_rank: Super Contributor
timestamp: May 20, 2025, 12:34:41 pm
content: Quote from: tggzzzI hope you don't think I'm claiming my opinion has "global applicability".My opinion is that this is one policy area where the rational public policy and the rational personal policy can differ, even conflict. Thus the individual who feels that way must be proactive in order to meet their needs.

author: bdunham7
author_rank: Super Contributor
timestamp: May 20, 2025, 12:46:30 pm
content: Quote from: EEVblog on May 20, 2025, 10:02:09 amThe trend, or PSA velocity, is what my doctor says is important and that's why I get an annual PSA test. This notion--even if correct-- that not knowing is better because the harms from the actions taken as a result of knowing are statistically worse than doing nothing seems to me to be poorly thought out. I would instead propose modifying the actions taken in response to an elevated or rising PSA.

author: nctnico
author_rank: Super Contributor
timestamp: May 20, 2025, 01:09:11 pm
content: Quote from: PlainName on May 20, 2025, 08:48:35 amOne thing to keep in mind is that medicine isn't an exact science. Everyone is different so every case is unique. You can only go by what is (statistically proven) better in the big picture compared to nitpicking edge cases. Over-treatment is a seperate problem.

author: tggzzz
author_rank: Super Contributor
timestamp: May 20, 2025, 01:14:26 pm
content: Quote from: SteveThackery on May 20, 2025, 12:34:41 pmYour statements were suitably qualifiedI don't have (many) issues with individuals being proactive on their own behalf."Rational personal policy" is not too far off being an oxymoron. People usually don't know/understand enough (neither do healthcare professionals), and tend to be emotional about cancer-risks vs other-risks. Besides probability is a minefield, e.g. each individual has a 50% chance - either yes or noSuch considerations are definitely a consideration w.r.t. breast cancer screening, where there are too many "think about the women" and "do everything possible" campaigns/campaigners. IMHO PSA screening is even more problematic.It is a difficult subject, in all sorts of dimensions.

author: EEVblog
author_rank: Unknown
timestamp: May 20, 2025, 02:19:23 pm
content: Quote from: SteveThackery on May 20, 2025, 11:17:55 amThanks for sharing. Sorry to hear about your diagnosisQuoteIt's actually auotmatically requested by your doctor in Australia when you get a regular yearly blood test, along with a whole host of other stuff.or at least it should be if your doctor is competent and following the guidelines.Used to be every year, but now they changed it to 2 years unless you have family history.One interesting thing my regular blood test showed up 4-5 years ago was my uric acid level was very high. The doctor knew straight away: "You take pea protein powder don't you?"Yup, I quit that the next day.

author: EEVblog
author_rank: Unknown
timestamp: May 20, 2025, 02:29:54 pm
content: Quote from: jpanhalt on May 20, 2025, 12:13:17 pmYes, this is what my doctor is looking for, a significant change.As I said, i have a solid history of all my values being 0.9 - 1.0, so if it starts going to go up, it's worthy of investigation.

author: SteveThackery
author_rank: Super Contributor
timestamp: May 20, 2025, 02:34:22 pm
content: Quote from: tggzzz on May 20, 2025, 01:14:26 pmNot at all. There are plenty of irrational personal policies.I think you have misunderstood my point. From the point of view of the individual it is rational to get a PSA test annually. There are no downsides. You might argue that a false positive is a downside, but it isn't if the individual understands that and has taken that risk into account. The alternative is to not have a PSA test and live in ignorance. Speaking rationally, there is no upside to that. Remember, I am speaking rationally, not emotionally. From a rational perspective, data is always better than no data, provided the individual is informed about the reliability of that data. So wanting an annual PSA test is entirely rational.But that does not apply to the state. Annual PSA testing for all males over - what, 50? - is a bad policy because across the population as a whole the benefits do not outweigh the costs. This leads to the interesting situation where a truly rational "Head of Policy" (assuming it's a man) must recommend against population-wide PSA testing whilst booking a PSA test himself. Both acts are rational.There is nothing unusual in the situation where what makes logical sense at an individual level doesn't make logical sense at a population-wide level, and vice versa.Quote from: tggzzz on May 20, 2025, 01:14:26 pmI saw the smilies but I'm going to respond anyway: the probabilities of 'yes' and 'no' are not 50% each when it comes to medical tests.

author: EEVblog
author_rank: Unknown
timestamp: May 20, 2025, 02:49:30 pm
content: Quote from: SteveThackery on May 20, 2025, 02:34:22 pmCost cutting is why they reduced it here from 1 year to 2 years.Although I wonder how many otherwise healthy men get a regular yearly blood test like I do. No ready data it seems, but Grok guesses only 20%-30% of men 40+ in Australia get a regular blood test.I suspect it's way lower than that in healthy men who proactively choose to get it done. You know, there is some truth in the whole "men would have to have a limb fall off to go see doctor" stereotype.

author: bdunham7
author_rank: Super Contributor
timestamp: May 20, 2025, 03:22:02 pm
content: Quote from: SteveThackery on May 20, 2025, 02:34:22 pmI call this "livestock theory" and it applies to more than medical situations. If a pig farmer sees three of his pigs ganging up on a fourth and killing it, he's lost a pig. If the victim pig pulls out a gun and kills the three pigs attacking it, the farmer has lost three pigs. So the pig farmer has a different view on self-defense rights than the individual pig. I guess the same goes for PSA tests and many other things and IMO it raises serious ethical questions as to the role of government or other "authorities" in these issues. Big-government and central-control types use terms like "collective action problem" and "tragedy of the commons" to describe their views on the issues, but IMO reasonable educated individual decisions are a basic human right. Idiotic decisions, maybe not--but where do you draw that line?

author: tggzzz
author_rank: Super Contributor
timestamp: May 20, 2025, 03:40:27 pm
content: Quote from: SteveThackery on May 20, 2025, 02:34:22 pmOxymoron, not tautology.If personal policies aren't (in this context) rational, then "irrational" is the alternative.QuoteThe real downside is mental and/or physical harm caused by a false positive. Everything I read indicates that isn't trivial.QuoteI can't believe that I - a confirmed pessimist - am saying this, but absence of worry is valuable in itself. There's no point in doing a test if the result won't change the outcome.Example: when my wife about to have the routine amniocentesis test to detect foetal abnormalities, she was specifically asked whether a positive result would lead to abortion. At first sight that's shocking, but since the amniocentesis test carries risks, it is exactly the question thatshouldbe asked.QuoteAs an engineer who keeps a paper record ofalltest results, and if there are three or more I will draw a graph, I ought to agree. But in this case I don't.My gut (ho ho) feeling 15 years ago was that the known high false positive rate followed by treatment with side effects was not a good tradeoff. The high false positive rate is still there, but ameliorated by a more nuanced interpretation. The treatment is now far less gung-ho than back then.Hence the balance has (at first glance) swung towards annual testing. But instead the more subtle knowledge leads to the sensible outcome being no blanket screening testing. (But do test if there is a known reason an individual might be at increased risk).QuoteAny rationality (of choosing an individual test in the absence of any reason to believe a test is necessary) has to be based on an individual's personal attitudes to uncertain risks and rewards.QuoteCompare and contrast with the concept of "The Tragedy of the Commons".QuoteYup. I like poking people to make them think about what stats mean. The other example I use is to point out that it expected that 90% of a company's employees will receive less than the company average wage.

author: tggzzz
author_rank: Super Contributor
timestamp: May 20, 2025, 03:47:23 pm
content: Quote from: bdunham7 on May 20, 2025, 03:22:02 pmNo, it really doesn't; the two examples are not comparable.Come up with better analogies and I might agree. But note that analogies usually generate more heat than light: people start arguing about the analogy rather than the actual situation.QuoteThat's a very USA-centric attitude to civil society, verging towards a libertarian stance.

author: SteveThackery
author_rank: Super Contributor
timestamp: May 20, 2025, 03:56:07 pm
content: Quote from: tggzzz on May 20, 2025, 03:40:27 pmAgh! Thanks for picking that up.Quote from: tggzzz on May 20, 2025, 03:40:27 pmAnd 50% of the kids in your child's class are below average. (Caveats apply.)

author: jpanhalt
author_rank: Super Contributor
timestamp: May 20, 2025, 03:59:34 pm
content: What is the value of an "annual physical" for otherwise healthy individuals?Many studies dating back at least to the 60's show there is very little value. Is it cost effective? That depends on the cost of the very few new conditions that are found. One must also consider costs that are not so obvious in the cost for an annual physical. Some physicians for whatever reason (malpractice is usually given as an excuse) treat the numbers without even having a clue what could be wrong. That is, no patient complaints and a completely normal physical exam and history, so they order more tests, more inconvenience, and even (if they are not competent) do invasive procedures.I saw a very sad case in school involving a previously healthy teenage girl. One of her "liver enzymes" was slightly elevated. Her physician decided to do a liver biopsy. Negative. So, he did another and another (I don't remember how many). When I saw her, she had developed a deep liver abscess. It was open to the outside and we had to do debridement. You could put your whole hand in the open wound. From no symptoms and healthy, she went to being hospitalized for a lengthy time. I did not get to see her discharge. To me, that was malpractice. It was not "being thorough."As another example, slightly elevated serum calcium used to prompt all sort of additional workup. I think that practice has probably ended. Some other usually worthless tests are serum chloride and carbon dioxide.My recent exam had 25 "tests" done of which a few were calculated results, such as "risk factor" for cardiovascular disease. The vast majority were worthless. My serum sodium came back as 133 mEq/L (136-145 mEq/L). My chart created by computer diagnosed me as hyponatremic with a recommendation for retesting in 4 to 6 weeks. Of all of those tests, the only ones of interest to me and my PCP were: PSA, free T4, TSH , and 5 others. The thyroid tests and PSA were specifically ordered based on my history. So, of 22 "standard tests" only 5 were useful in the context of checking liver and kidney function and cardiovascular risk in an elderly man. Simply put., it is less costly to do a panel than individual tests.Most important, one must have confidence in the physician or nurse practitioner they see that "abnormal" results will be considered in context and not be chased down as numbers.Back to PSA: Like other cancers, prostate cancer can be indolent for a long time and then take off. I would get an annual PSA regardless of what my government said.

author: tggzzz
author_rank: Super Contributor
timestamp: May 20, 2025, 04:28:47 pm
content: Quote from: EEVblog on May 20, 2025, 02:49:30 pmThanks for noting the source; that's important.Does that 20-30% mean grok is more or less certain than it is about whether 6 million Jews were killed in the Holocaust?https://eandt.theiet.org/2025/05/19/musks-grok-ai-chatbot-sparks-controversy-yet-again-time-holocaust-scepticismIt is worth noting that grok's earlier "white genocide" conspiracy statementshttps://eandt.theiet.org/2025/05/15/musks-ai-chatbot-grok-injects-white-genocide-unrelated-queries-xare being blamed on "an employee who “hasn’t fully absorbed xAI’s culture yet” ". It doesn't mention whether that employee is Musk himself, since it is apparently "a narrative that South African-born Musk has referenced many times through his own posts on X."

author: jpanhalt
author_rank: Super Contributor
timestamp: May 20, 2025, 04:34:50 pm
content: FYII asked Grok and Google what the usual actual reimbursement was for a PSA(total). Got the usual well it depends bla bla. The CPT code (what is used in the US for determining reimbursement and charging) for total PSA is 84153. So, I went to dot gov and checked the MAXIMUM reimbursement Medicare pays for that code:

author: PlainName
author_rank: Super Contributor
timestamp: May 20, 2025, 04:51:21 pm
content: QuoteThere seems to be a misunderstanding. No-one here has suggested that not knowing is better. Perhaps Dave's response convinced the quick reader that it had been, but that's not the case. What was said was that testing can, for various reasons, throw up cases which unnecessarily lead to surgery, and previously many of these wouldn't have. That's not a recommendation, no matter how much y'all would like to make out it is.How you deal with that potential is up to you, and itcanbe a problem. Perhaps not knowing that surgery wasn't necessary is better when you can't get a stiffy - is that what you're getting at?

author: tggzzz
author_rank: Super Contributor
timestamp: May 20, 2025, 05:30:56 pm
content: Quote from: PlainName on May 20, 2025, 04:51:21 pmIn some cases not knowingcanbe better. Consider the consequences of the placebo (or worse nocebo) effect,especially(but not only) where doing nothing is the right choice for a variety of reasons.That's highly dependent on the circumstances and the individual, of course.QuoteNo idea who "you're" refers to, and can't be bothered to disinter posting history.

author: RJSV
author_rank: Super Contributor
timestamp: May 20, 2025, 10:02:30 pm
content: Reading all of the various positions regarding testing, Dave is right, for the regular PSA being emphasized. I have a story regarding CANCER initial screening by my doctor...this is a person that, no doubt, received straight A's in school...:I HAD been raising an alarm flag, with 50 lbs sudden weight loss, (220 down to 153, actually. No response from my (smart ?) principal doctor. I had to resort to gossipy / political means to get her attention. What I mean by that, is that I had to bring my weight loss to the attention of one specialist, my rheumatologist, who then dutifully raised alarms...to the principal doctor.Then, all hell breaks loose, as my principal doctor scrambles to cover ass (she had ignored my sudden weight loss). Asking for permission, to start up a 'work up' she called it:"What's a CANCER workup ?". I asked:"We do a series of M.R.I. and CT scans.". She replied, and had no interest in doing ANY verbal screening.I was thinking, expensive and a hassle for myself, as MRI can be unpleasant even painfull.When I expressed this, I got an ear full:"What do you care", she said: "you're not paying for it!", and hung up phone, rudely.My point, in all this, is that common sense 'simple' was not happening, (like, for example, asking if I vomit or pass out).Doctor just went straight to the (expensive!) government funded testing....no 5 minute series of screening questions.MRI I found to be very cold, very loud, and cost me $150 transportation, as patients are drowsy and need a reliable and safe trip home.

author: tggzzz
author_rank: Super Contributor
timestamp: May 20, 2025, 10:11:35 pm
content: Quote from: RJSV on May 20, 2025, 10:02:30 pmThat doesn't sound like screening for PCa, and if that's the case then a PSA test would have been irrelevant.The rational for screening for one condition bears zero relationship to screening for a different condition.

author: RJSV
author_rank: Super Contributor
timestamp: May 20, 2025, 10:18:30 pm
content: Yes, no relation, which is my point, that (my) doctor was operating in a very lazy and irresponsible way. Just screening by way of complex and expensive 'hunt', or shotgun approach (to complaint of sudden weight loss). I've since obtained a new GP.

author: 5U4GB
author_rank: Super Contributor
timestamp: May 20, 2025, 10:25:25 pm
content: Quote from: EEVblog on May 20, 2025, 01:44:58 amPSA tests are a great example of the base rate fallacy in action, and cause more harm than good (even the guy who created the test has complained about this). Of people who get PSA tests, 1 in 100 will die of prostate cancer (with or without screening) but 20 in 100 will get false positives (or benign forms) and undergo the trauma of unnecessary treatment or biopsies because of the PSA test results even though they wouldn't die of prostate cancer (for example a 2005 study found that 40% of men who died of non-cancer causes had evidence of prostate cancer).There are similar issues around breast cancer screening, but the reaction to bringing that up in public (so not here but e.g. in the media) is akin to standing on a hilltop in a thunderstorm wearing wet copper armour and shouting "All gods are bastards".

author: tggzzz
author_rank: Super Contributor
timestamp: May 20, 2025, 10:27:17 pm
content: Quote from: RJSV on May 20, 2025, 10:18:30 pmThere are suboptimal professionals in all jobs, everywhere. That is irrelevant to whether a specific screening test should be undertaken.I hope your new GP is an improvement.

author: jpanhalt
author_rank: Super Contributor
timestamp: May 20, 2025, 10:31:32 pm
content: @RJSVSo you made a poor choice of doctor, if what you say really happened. That's no one's fault but your own. MRI and CAT scans are not painful. Your sedation was probably your choice and not required, but you haven't given enough detail to be sure.Bottom line, you like to complain about everything medical but aren't willing to make informed decisions about your own care. Some of your tales stretch credibility.

author: 5U4GB
author_rank: Super Contributor
timestamp: May 20, 2025, 10:40:43 pm
content: Quote from: tggzzz on May 20, 2025, 11:41:00 amI don't know about the UK specifically but in some countries, Canada being an example, the policy is based on hysteria rather than statistics: When some medical group (unfortunately I don't have the exact ref handy, it was doctors involved with cancer treatment) pointed out that many mammograms were at best useless, at worst harmful, the media, politicians, and women's groups went nuts and practically crucified the people who'd suggested basing things on statistical evidence rather than warm fuzzies. As a result the policy was left in place, causing more harm than good.To put this in perspective, prostate cancer has about the same mortality rate and age class as breast cancer, but there's no anxiety among men as there is for women and it's (correctly) presented in the media as an old person's disease. Colorectal cancer, close behind the other two, is virtually ignored.Even just the term "cancer" has magical significance compared to the typical causes of death, if you've got different types of heart problems (the top killer by far) you take blood thinners and keep going, if you've got breast or prostate cancer (which don't even make the top ten) then it's seen as a death sentence.

author: Analog Kid
author_rank: Super Contributor
timestamp: May 20, 2025, 10:41:53 pm
content: Quote from: jpanhalt on May 20, 2025, 10:31:32 pmI find your reply quite unhelpful, and certainly fallacious.This whole "you must take responsibility for your own medical care" absolves doctors of a lot of responsibility. After all, why do we even have doctors in the first place? They're trained medical professionals and we're not; they read medical journals and keep up on the latest treatments: are we expected to do the same? Of course not.So the doctor is supposed to be ten steps ahead of us. Sure, we might choose a subpar doctor: it's happened to me. First of all, how the hell are we supposed to even know that's the case when we choose one? Generally the most info we're going to have on a selection of drs., assuming we even have a choice (not always the case: the clinic I go to is so understaffed and underpaid that there are no MDs, and few drs. to choose from) will be a single-page CV of some sort.So enough with blaming the patient here, 'K?

author: thm_w
author_rank: Super Contributor
timestamp: May 20, 2025, 10:53:38 pm
content: Quote from: jpanhalt on May 20, 2025, 10:31:32 pmDon't think they were sedated, your body literally heats up by 10-40W/kg when you are in an MRI scan which can make you feel a bit off. Its not massive, but I always get headaches from it.https://onlinelibrary.wiley.com/doi/10.1155/2019/9618680

author: tggzzz
author_rank: Super Contributor
timestamp: May 20, 2025, 11:09:40 pm
content: Quote from: 5U4GB on May 20, 2025, 10:40:43 pmI haven't followed the breast cancer screening story, other than to note that it isn't clear cut and that it is difficult to present the subtle statistics in a way that can be understood by the public (and GPs). The illustration I included earlier is regarded as the best presentation technique, but ISTR I've seen similar diagrams that we include more information about the various outcomes.As to public reaction, I didn't pay much attention, but ISTR hearing the predictable and understandable objections from enthusiastic amateur organisations promoting screening and awareness.PCa screening has similar tradeoffs, but there are campaigns promoting awareness of PCa. Those are based around the concept of "if there is a symptom, then get it examined and tested", not population screening.PCa is starting from a lower awareness threshold, so although the issues are comparable, there isn't a negative reaction to less screening.And yes, cancer is a magic bogey word, and our disreputable newspapers play on that. One newspaper, the DailyMailWail is infamous for targeting the "worried well" by running stories which divide chemicals and causes into two categories: cancer causing and cancer curing. Amusingly some appear in both categories.

author: EEVblog
author_rank: Unknown
timestamp: May 20, 2025, 11:20:29 pm
content: Quote from: 5U4GB on May 20, 2025, 10:40:43 pm1) In Australia colorectal (bowel) cancer is not virtually ignored. In fact when you turn 50 you automatically get a poop screening kit in the mail every year. It's jokingly referred to as the "Oh shit, I'm 50" kit.2) Apart from the poop test which just looks for traces of blood, there is no other easy marker test for it like there is for prostate and breast cancer. Almost nobody wants a probe shoved up their arse in a colonoscopy, and a CT scan isn't exactly cheap.

author: tggzzz
author_rank: Super Contributor
timestamp: May 20, 2025, 11:33:33 pm
content: Quote from: Analog Kid on May 20, 2025, 10:41:53 pmNot just doctors. It enables politicians, companies, neighbours, everybody to say "you chose not to take care of yourself, so you are not worth helping and I don't care".Very cruel and un-Christian.

author: EEVblog
author_rank: Unknown
timestamp: May 20, 2025, 11:34:29 pm
content: Quote from: tggzzz on May 20, 2025, 03:40:27 pmYou do you.Others that have the mental fortitude to handle and deal with a changing PSA result will happily and rightly get their yearly PSA test. Stop trying to convince them otherwise.I for one am very happy that my tax dollars are spent on having things like PSA and other blood tests covered under medicare, than the crap they otherwise spend it on.

author: Bud
author_rank: Super Contributor
timestamp: May 20, 2025, 11:40:05 pm
content: MRI is annoying and boring, but if they give you the images it is fun to load them into a suitable software and explore yourself from inside, lol.

author: tggzzz
author_rank: Super Contributor
timestamp: May 20, 2025, 11:41:36 pm
content: Quote from: EEVblog on May 20, 2025, 11:20:29 pmAnd yet that is exactly what happens with a positive PSA result - false or not.In fact it is worse: a "snake" bites a dozen bits out of your prostate, with consequent risk of infection/sepsis. Even then the biopsy can physically miss sampling cancerous tissue.Overall the sensation can be described as "the shot fights back".

author: tggzzz
author_rank: Super Contributor
timestamp: May 20, 2025, 11:43:04 pm
content: Quote from: EEVblog on May 20, 2025, 11:34:29 pmPlease don't make strawman arguments.Please read all that I have written.I too am very grateful that the tests exist; they saved my life.

author: bdunham7
author_rank: Super Contributor
timestamp: May 20, 2025, 11:43:42 pm
content: Quote from: Analog Kid on May 20, 2025, 10:41:53 pmA discriminating and educated consumer is necessary for any market-based system to work. The alternative is heavy-handed regulation. If you do not put the effort into choosing a doctor and understanding your medical care, whether by choice or inability, your typical outcomes are often significantly worse. For example, if someone you care about is in the hospital and is incapacitated to any extent, then you need to be there full time to be their advocate and to monitor what is going on. Is it your job? No, but reality is that in most cases no single person working in that hospital will be as focused on that patient as you are. Now if you truly have no good options for doctors, that sucks. It took me 3-4 tries each time to find a PCP that I thought was good.

author: tggzzz
author_rank: Super Contributor
timestamp: May 20, 2025, 11:48:30 pm
content: Quote from: bdunham7 on May 20, 2025, 11:43:42 pmGood luck choosing which A&E department the ambulance takes you to.Good luck assessing each and every professional you might needin advanceof needing them, and hoping your choice is available.

author: Analog Kid
author_rank: Super Contributor
timestamp: May 20, 2025, 11:50:04 pm
content: Quote from: bdunham7 on May 20, 2025, 11:43:42 pmJust to focus on this one issue, as I wrote, how the hell are we supposed to choose a doctor (ifwe have the choice at all) when all we get is a one page (or less) blurb on them, maybe with their picture?I figure the odds of getting a good doc are just about as good rolling the dice here, as making some kind of "informed choice".

author: EEVblog
author_rank: Unknown
timestamp: May 20, 2025, 11:51:23 pm
content: Quote from: bdunham7 on May 20, 2025, 11:43:42 pmWhen I busted my ACL I didn't just book into the local hospital for the surgery, getting whatever work experience student was on that day, I actively seeked out the best ACL knee surgeon in the country. I even read his research papers (he was a world leading ACL surgery researcher). The result is my knee is better than it was before. And it also meant I ended up with one the best anesthetists in the country (he was the head of the anesthetist association), because the best like to hang around with the best.My brother in law took the former option and has regretted it ever since.I also literally take my thermal imaging camera into my doctor and physio to show them exactly what problem I have, rather than have them guess.Doing all this doesn't guarantee me a better health outcome, but it sure increases the odds.

author: tggzzz
author_rank: Super Contributor
timestamp: May 20, 2025, 11:51:33 pm
content: Quote from: Analog Kid on May 20, 2025, 11:50:04 pmPrecisely.

author: tggzzz
author_rank: Super Contributor
timestamp: May 21, 2025, 12:00:51 am
content: Quote from: EEVblog on May 20, 2025, 11:51:23 pmThat's the ideal, but it isn't easy to achieve.We managed it by accident for my daughter's surgery; while agonising over what to do, we saw him profiled in a 30minute BBC "your life in their hands" programme. After the 8hr surgery he flew off through a hurricane in Miami to teach Americans how to do the operation.Two decades later he was sued by several people for negligence, and had conditions imposed on what he was allowed to do.

author: bdunham7
author_rank: Super Contributor
timestamp: May 21, 2025, 12:21:44 am
content: Quote from: Analog Kid on May 20, 2025, 11:50:04 pmFor a PCP or even some specialists, you can try them and see how you like them. It isn't just a matter of skill level, it's organization, responsiveness, diligence, etc. For one-time events like a surgeon, you can and should get a LOT more information about the provider and the facility. I'm lucky in that I'm within driving range of one of best hospitals (world wide) for orthopedics and my insurance is valid there. It's a lot less convenient and sometimes involves staying in a hotel, but for something that counts it is worth it. For the surgeon I researched extensively and I found this obscure journal for foot/ankle specialists that had an article summarizing a survey they had done (of foot/ankle surgeons) asking them who they regarded as the best. They listed the top 23 (why 23 IDK) in the US and my guy was on that list. I spent a lot of time researching the details of the complex surgery, finding that journal, etc.I knew a guy who was an anesthesiologist and he needed hip replacement or surgery. He had a new (at the time) procedure known as resurfacing done. The idea is that instead of the smaller ball/socket that is typically used, they replace the contact areas of the hip only, but the parts are larger (original size) and hold up better. The first hip was done by a super-specialist that had played a big part in developing the process. He had to travel about 100 miles and stay in a distant hospital, etc so it was inconvenient but it turned out well. By the time he was ready to the the second one, an orthopedist at the local hospital where he worked had gone through the training and was offering the procedure. Since it was more convenient and it sort of looked bad for him to not get an operation done at the place he worked (which was fairly reputable, not some third-rate inner city or rural setting) he had the local guy do it. During his recovery his femur broke off just below the head. That resulted in significant consequences. IDK exactly why or whether the result would have been different if he had gone back to the first surgeon, but I strongly suspect he regrets his choice.There is some element of chance, but a good PCP will have some awareness of where you should and shouldn't go. I had a significantly sub-par experience with a specialist at my local hospital and my PCP was very unhappy and let me know that he "didn't know that guy", IOW implying I should go elsewhere. In retrospect I didn't respond to that hint quickly enough (I took it as a neutral, not a negative) and nowadays I'll bail at the first sign of any lack of excellence. I now drive over 100 miles round trip for an annual ultrasound study rather than have it done locally because there is a HUGE difference in the quality and it is readily apparent even to me, no technical understanding required.

author: Analog Kid
author_rank: Super Contributor
timestamp: May 21, 2025, 12:58:56 am
content: So to summarize:Taking responsibility for one's healthcare outcome is a good thing, if one is in a position to do that.But ultimately, the outcome of any healthcare situation is basically a crap shoot, even if one has all one's ducks lined up in a row: even given the most qualified surgeon/diagnostician and healthcare facility, Nature has a way of intervening under the best of circumstances and imposing Her Will on the situation.Those who aren't able to Take Reponsibility for Their Medical Outcomes are destined to suffer the consequences of the medical-care system they live under.

author: EEVblog
author_rank: Unknown
timestamp: May 21, 2025, 01:44:35 am
content: Quote from: Analog Kid on May 21, 2025, 12:58:56 amLess a crapshoot, more a Murphy.You can certainly vastly increase your odds of a good outcome by gaming the system and making smarter choices (if you are able to).One of the things I learned very early on in life was that the best thing you can do is to have your own health insurance. By that I mean having savings specifically devoted to anything medical that might arise, so that when the time comes you can make your own choices, get the best tests, chose your own surgeon and the top specialists etc.Of course that doesn't mean not having private health insurance, I still have that for if I needed to stay in a hospital for 6 months, they'd put me in a better local private one instead of the overburdened public hospital. But it means that I have the money to pay one-off for the top surgeon in the country if needed, I don't even need to think about that twice.

author: RJSV
author_rank: Super Contributor
timestamp: May 21, 2025, 02:10:51 am
content: As to any 'subpar' doctor, I did mention that Dr. R.S. was a straight A type, and she had been selected to inherit the large practice, upon age and mortal illness of the former clinic owner. She was recommended by my opthalmologist and did seem very smart.But it was the attitude, where many complaints got the block...you know; THE BLOCK, where the head shakes and insulting remarks are uttered. Medical POT controversies, and the whole Lyme Disease controversies didn't help, as she started using the term 'Just like a street person...ON METH !'(Lyme Disease, I've seen described as a 'catch-all' term for a whole series of 'vague' disorders....Oh Great, ...now I have to defend the disorder, including having a valid ICD category, as a bogus ailment...lol.)When I did get mad enough to switch, I then found, exactly ONE doctor in my area (Oakland region), who was taking new patients.O.K. to go ahead (or continue) to doubt my narrative, it doesn't match the glitzy adverts (United Health Care HMO).Exactly ONE doctor, and he didn't have initial appointment for something like 4 1/2 months later. I could have seen other new doctors, but at 25 miles distant (I don't own a car, so....).No usefull reviews in choosing this one single doctor.His staff seems to dictate everything that takes place, while he passively goes through the motions. Another smart doctor, to replace the former smart / rude doctor. I did have a U.S. born doctor once, a few decades ago.Better comments here come from U.S. location, for eevblog. Many in the U.S. understand the meaning of the statement:WORST health care system ever. (Emphasis added).

author: tggzzz
author_rank: Super Contributor
timestamp: May 21, 2025, 07:52:23 am
content: Quote from: EEVblog on May 21, 2025, 01:44:35 amJust so.But your caveats are very important: many people are never competent to make a good choice, and everybody can be incompetent at critical points in timeEven after a competent choice has been made, sh1t happens

author: EEVblog
author_rank: Unknown
timestamp: May 21, 2025, 08:01:35 am
content: Quote from: RJSV on May 21, 2025, 02:10:51 amEvery else in the world just looks at the medical situation in America with utter bewilderment.Unfortunately Fran has found herself on the end of the US medical beating stick:https://www.gofundme.com/f/get-fran-healthcare-for-2025

author: tom66
author_rank: Super Contributor
timestamp: May 21, 2025, 08:15:51 am
content: Dr. Rohin Francis, an NHS consultant cardiologist, gives his view on this "overtesting" phenomena common to the USA, and why it is irrational.

author: tggzzz
author_rank: Super Contributor
timestamp: May 21, 2025, 09:23:36 am
content: Quote from: tom66 on May 21, 2025, 08:15:51 amAs someone who doesn't like videos, especially talking head videos, that one makes good points.A few examples in the video:in many cases people who know how screening/scanning worksand failsare recommending against it -even though they would benefit financially from more screening/scanningscreening leading to increased survival-time-with-X is irrelevant. What matter is life expectancy. It is entirely possible that better testing leads to earlier diagnosis, but you still die at the same age. In such cases, better testing has not improved anythinga test's success probability on its own is useless; you also need to factor in the disease incidence. When that is done it can be seen that there can be far more false positives than true positives. And if those false positives lead to risky invasive procedures, overall testing can cause more problems than it solvesS Korea had one particular cancer with soaring incidence rates, but the mortality rate stayed the same. After an aggressive campaign against that screening, mortality rates remained the same. Conclusion: overdiagnosisif there is earlier diagnosis then insurance becomes more expensive. In the civilised world that's travel insurance, but in the US it can also mean that you cannot transfer from onedeathinsurance company or plan to another - and there can be subtle lethal consequences which too long to mention here

author: 5U4GB
author_rank: Super Contributor
timestamp: May 21, 2025, 09:41:12 am
content: Quote from: tggzzz on May 20, 2025, 11:09:40 pmYeah, it's really tricky. The examples I gave come from statistics texts looking at things like the base rate fallacy and similar problems, made even more problematic when you have to give it in terms of x-year survival rates for something at an age range where people are often going to die anyway with or without the disease, and with or without it causing the death. For example if someone dies of XYZ cancer at age 70 and one country screens at age 50 then the 5-year survival rate is 100%, if a second country screens at age 65 then the 5-year survival rate is 0%. Same issue, same screening text, but completely opposite results.So in theory if/when you get a positive result from a test the next step isn't to consider yourself at death's door but to ask what's the base rate, what's the 5, 10-year survival rate, what's the impact of unnecessary chemotherapy/surgery if it's a false positive, etc. Unfortunately GPs and similar just aren't set up to answer that since it's such a deep-dive specialised topic, and since 99.9% of patients would never ask it and/or wouldn't understand the answer.For people interesting in more reading on this, psychologist Gerd Gigerenzer has spent a lot of time trying to figure out how to communicate risk issues in an understandable manner, he runs the (quick Google)Harding Centre for Risk Literacyand has written a number of books on the topic.

author: tggzzz
author_rank: Super Contributor
timestamp: May 21, 2025, 09:42:24 am
content: Quote from: 5U4GB on May 21, 2025, 09:41:12 am... and with zero benefit to the patient.To clarify the base rate fallacy, seehttps://en.wikipedia.org/wiki/Base_rate_fallacywhich contains this useful picture. With just a little thought this example can be applied to screening results.I wonder if the people who deny covid vaccination effectiveness (because they don't understand the base rate fallacy) are also going to fall into the same trap w.r.t. screening?

author: 5U4GB
author_rank: Super Contributor
timestamp: May 21, 2025, 09:56:18 am
content: Another example of this is the Linda Problem:Quote80% of people chose (2) as the answer.

author: EEVblog
author_rank: Unknown
timestamp: May 21, 2025, 10:22:46 am
content: Quote from: 5U4GB on May 21, 2025, 09:41:12 amWho on earth would just take an elevated positive PSA result and go get their affairs in order or jump straight into some extreme procedure?This is just too stupid to even discuss.Depending upon the circumstances the GP would refer you to a prostate specialist who would then possibly order more tests (likely over the long term to see further trend etc) and discuss the whole situation to you over time.I think this thread is getting out of control.

author: tszaboo
author_rank: Super Contributor
timestamp: May 21, 2025, 10:31:47 am
content: Quote from: EEVblog on May 21, 2025, 10:22:46 amIt's a screening test, that is being sold for 7 EUR in the local pharmacy. This is already with profit.Testing every year from 50 will cost less than any medical procedure.Whoever is advocating for not doing it is so ant-human it just blows my mind. It's the equivalent to that politician who was advocating for paying the 13th month pension in April cause people will die by then and the government can save a bunch of money with that (not in Netherlands)

author: tggzzz
author_rank: Super Contributor
timestamp: May 21, 2025, 11:00:02 am
content: Quote from: tszaboo on May 21, 2025, 10:31:47 amAnd that's a major part of the problem.QuoteBut the significant proportion of false positives will lead to a significant number of unnecessary and/or harmful expensive medical procedures.QuoteI don't doubt it. But that indicates more about your mind than anything else.Do have a look at the video tom66 indicated. It directly addresses your misapprehensions; whether or not you mind can be changed is a different issue.

author: EEVblog
author_rank: Unknown
timestamp: May 21, 2025, 11:13:47 am
content: I have split this thread out so it's at least sensibly categorised and searchable now.I'm no longer going to argue with anyone that testing for prostate cancer is a bad idea. You do you.

author: EEVblog
author_rank: Unknown
timestamp: May 21, 2025, 12:07:58 pm
content: Umm... what happened to the original topic thread?I can't find it on search or browseI just used the usual Split Topic function that has always worked

author: EEVblog
author_rank: Unknown
timestamp: May 21, 2025, 12:09:44 pm
content: Quote from: EEVblog on May 21, 2025, 12:07:58 pmFound ithttps://www.eevblog.com/forum/chat/newspapers-publishers-distributor-and-possibly-its-website-racist-remarks/Had to use google search

author: Seekonk
author_rank: Super Contributor
timestamp: May 21, 2025, 12:50:46 pm
content: So Biden hasn't taken a PSA test since 2014 just to save $15? I'm way into my 70's and still get them. Does anyone believe he wasn't getting them every year?

author: SteveThackery
author_rank: Super Contributor
timestamp: May 21, 2025, 12:57:11 pm
content: Quote from: EEVblog on May 21, 2025, 10:22:46 amMe too. People are taking ridiculous positions just to "win" some confected sub-argument.

author: tggzzz
author_rank: Super Contributor
timestamp: May 21, 2025, 01:16:30 pm
content: Quote from: Seekonk on May 21, 2025, 12:50:46 pmPossibly not, but not to save money!There are possible reasons which could have made sense to him

author: rdenney
author_rank: Regular Contributor
timestamp: May 21, 2025, 04:24:26 pm
content: Story: I had trouble urinating, which was getting worse. I visited my general practitioner, and he performed a DRE and a blood test. The DRE results was "enlarged, not lumpy, appropriate for someone who is 75." I was 60 at the time. He prescribed tamsulosin (FloMax), which caused my blood pressure to plummet and earned me a trip to the ER after losing consciousness. (This is an uncommon but not rare side effect.) I called my doc back to complain about the tamsulosin, and his response was "get thee to yon urologist, good sir, your PSA is at 7."I called the recommended urology group 35 seconds later, asking to be fit into what was normally a two-month backlog. "I'm sorry, we can't do that--what was the PSA count?" My response: "7." "Well, Mr. Denney, it looks like we can fit you in on Thursday."Are you getting false positive vibes? You shouldn't and I didn't, but I also immediately started the research. Did that cause me distress? Alarm, yes. Panic, no. And I just wanted to be able to pee reliably.The urologist suggests a staged approach. 1.) let's try an antibiotic just in case this is inflammation from a bacterial infection. If that doesn't work, we'll move on to Step 2. It didn't work. 2.) let's schedule a biopsy.The biopsyused to bepainful. Now, they do it under general anesthesia. The urologist described doing it without anesthesia as "cruel and inhuman punishment." For me, it was mildly uncomfortable for a while but nothing like painful, plus the rather frightening appearance of blood where one does not normally want to see it--in the cost/benefit category this did not come to me anything more than dollars.Result came back positive for prostate cancer, Stage I, with a Gleeson Score of 7.In the past a Gleeson 7 cancer would probably be in the "watch and wait" category, but that's because the traditional alternatives were:1.) Hormone therapy, which has side effects and limits, as we have heard in this thread.2.) Radiation therapy (including beads), which ultimately will damage tissue including the nerves that control things most men would like to be able to continue to do, and continence is only one of those things. But the real problem with radiation for a 60-year-old is that the tissue damage that results precludes the option of later surgery, or at least of later surgery with good outcomes. And there is a time limit, making this a better option for a 75-year-old than a 60-year-old.3.) Open surgery, which is major surgery with a long recovery period of 6-8 weeks.None of those are options one would want to consider if the risk is small. At Stage I with a lower Gleeson Score, the usual prescription would not just be frequent PSA test, but rather frequent biopsies.But there has been an innovation in the last couple of decades that changes the formula, it seems to me. It certainly changed the formula for me. And that is robotic laparoscopic surgery. This is the route that I took.I'm not gonna lie--the surgery was a big deal even with the robotic approach. 5 hours under the knife and about a month to fully recover. There was some pain, there was a week of catheter, drainage, and other unpleasantries. But the advantage is that a skilled surgeon can often save the nerves that control the things most men don't want to lose. For me, the long-term side effects have been minimal with very little if any effect on my life. There is no way in the world I would prefer to live with the cancer than have that surgery.Now, I get PSA tests only--without any prostate tissue in my body there should be zero PSA. I get the high-resolution test and the correct outcome is a PSA of less than 0.014 (the smallest number they can measure). If the PSA reappears, that means they missed something and then I can consider those other options.What all this tells me is that PSA is a screening tool, but like all quick and easy screening tools, might be subject to false positive and false negative error. But we know that already--an elevated PSA is no diagnosis of cancer--only a biopsy can do that--it's just a marker that might just as easily point to benign prostate hyperplasia.A DRE is just as indicative, and just as flawed. A prostate with a small, central tumor may feel normal (as mine did, even though mine was significantly enlarged). But combined enlargement or clinical indications from the DRE with an elevated PSA, and now it's time to look into it further. Even a biopsy might miss the tumor--they take 16 or so samples and might not catch it. But even if the biopsy misses it, continued clinical evidence from the DRE and PSA will mean another biopsy in a year.The goal is to catch it before it metastasizes.Some prostate cancer is slow-growing, but that isn't as common as lore would indicate, at least in my personal experience. I have known five people (including myself) with prostate cancer. Two of us have good long-term outcomes, and a third is still with us but it doesn't look good for him. The other two were gone within a year. Those are not statistics I'm prepared to put in the low-risk category.So, the game-changer from my perspective has been the robotic surgery with its smaller degree of invasiveness, faster and less painful recovery, and greater likelihood of preserving important functions. With that option available, watch-and-wait is less attractive for cancers that were clearly detected in a biopsy, especially for younger men for whom other treatments have limited outcomes. But that applies to those who catch it at Stage I. For those (including those in this thread) not so lucky, you just have to throw everything at it. My heart goes out to you.Rick "respectfully submitted" Denney

author: tggzzz
author_rank: Super Contributor
timestamp: May 21, 2025, 05:28:13 pm
content: Rick, your story closely matches mine, exceptmy post-PSA diagnostic tests made me dangerous to nearby people... Minor symptom mentioned as "oh, just one other thing" -> DRE -> PSA 24 -> Gleason 3+4, T3aM0N0I'm surprised you mention such a long time after surgery. I was kicked out the hospital within 24 hours, back to an empty house. However things didn't fully stabilise for about 6 months after that.A week after surgery my PSA was verbally reported to be 0.1, at which point the consultant started me on the pathway to high intensity "salvage" radiotherapy. Fortunately I checked, and the actual result was <0.1, which isverydifferent. Always get and keep all paper records of any testFor the past 10-15 years the diagnostic objective has been to classify the appropriate course of treatment: resection, chemical castration, radiation (at least 4 variants), cryo, and wait (3 variants).The post-PSA tests are themselves risky, and the treatments are allveryunpleasant in different ways.All of that adds up to the current advice:don't do "wellness screening", but dotest if there is a symptom.Pleasingly that matches my intuition before I knew anything more than PSA has many false positives and negatives. Clearly the profession has begun to see my wisdom I was told not to come into contact with a pregnant woman for 24 hours.

author: rdenney
author_rank: Regular Contributor
timestamp: May 21, 2025, 06:00:41 pm
content: Quote from: tggzzz on May 21, 2025, 05:28:13 pmOpen surgery will send you home in a couple of days, probably, but you'll be very limited in movements for weeks. The prostate is behind a bunch of stuff they have to go through to get to it. Robotic surgery might keep you in the hospital overnight (it did for me) but often enough it's outpatient surgery. But three weeks later I made the mistake of getting on an airplane, and either the altitude or lifting the bag into the overhead caused a fluid buildup in the surgery area that hurt like hell for about a week until it went down. Lesson learned. After the surgery, I was homebound for a couple of weeks, but really nailed down the first week what with the catheter and the drainage bag.I have a friend who was diagnosed a couple of months ago for the first time--Stage IV. His prospects are poor, though he is now transitioning from radiation to hormone therapy. His is a case of a false negative--he did have regular screening and never had symptoms until his back started hurting (after the cancer got into his bones). Nothing is perfect. But the PSA test never conducted is aguaranteednegative, not afalsenegative. And it is not the only routine screening tool.I absolutely concur with the distinction between a public policy evaluation and a personal decision. As long as it is true that PSA tests at least reasonably often find cancers early enough to be treatable, I'll recommend them to my friends. Same with the DRE as part of a routine physical.Rick "the DRE test goes with PSA screening" Denney

author: Gyro
author_rank: Super Contributor
timestamp: May 21, 2025, 06:11:28 pm
content: My story: I've recently had a relatively similar experience to rdenney: Back in 2019, flow a little slow but no other symptoms. My doctor ordered a PSA test which came back as at 7. I was referred to Urology, where they did an ultrasound, finger test - a little firm on one side (the prostate that is!) and a template biopsy. As above, not a worry under a general, a little painful to sit down afterwards (and you have to find and remove the tape before...!).My biopsy came back with low grade disease on, I think, 2 needles. I can't remember the Gleason score now,probably 6/77 irrc. I was put on active (3 monthly PSA) monitoring as one of the majority 'you've got it but it will probably not cause an issue during your lifetime' group. After the biopsy, my PSA dropped to around 2 or 3. It stayed pretty low for the next few years and then started slowly rising.The monitoring team said "if it goes up again on the next test we'll get you back in to see the consultant. It did, and last spring, when I saw him, he had plotted a perfect straight line slope from the previous 2 years of readings, something I should have thought to do myself. Manual examination revealed a definite hardness and misshape. Another template biopsy, this time showing disease in roughly 30% of the 34(?) needle samples but still low grade. I had a PET scan and contrast MRI which showed significant progression, but still contained within the prostate. We discussed the options of Radiotherapy (actually several months of hormone treatment followed by Radiotherapy) and surgery. The general consensus was a preference for surgery - I just wanted it gone, regardless of side effects (which you're likely to get whichever route) and the advice that it is very difficult to do surgery after radiotherapy (scarring) but easy to do the other way round.I was referred across to a university trust hospital, equipped with robotic surgery equipment. The surgeon I saw initially said he thought he could probably do partial nerve saving surgery, but the one who actually did the surgery said on the morning of the surgery he wanted it all out, different interpretations of the same MRI series. As rdenney said, about a 5 hour surgery with a da Vinci machine. All went well, overnight stay. The catheter for the first week was a pain, turning over in bed and constantly monitoring the sagging leg bag during the day. When it came out, I thought I would never stop peeing again but control came back quickly.At the follow-up appointment, the surgeon said that the histology results had actually come back as a Gleason 9 (5+4) grade 5 (the same as Joe Biden) and that the cancer had invaded the seminal vesicles and nerves, but not lymph nodes. His conservative approach of taking the nerves (the vesicles come out anyway) and as wide a margin as possible had paid off - even then, some of the margins had come back as 'equivocal' in the report. He said in a quiet voice that "I mightjusthave got away with it" although there was a chance of cells seeding in bone and other organs. I'm now on monitoring for the next 5 years, 3 monthly monitoring with my first two PSAs coming back as 0.01, which I think is the finest resolution that the test can achieve.I think I got lucky. The tests in the summer showing no spread made me eligible for surgery - current thinking (at least in the UK) is that once the cancer has spread, there is little benefit (compared to the side effects) of removing the prostate and that hormone, radiotherapy and chemotherapy are offered instead, so I might not have been referred for surgery. A very borderline case. My best wishes to those who have come out of the other side of the balance.On the flip side, my brain tumor has suddenly started expanding again and I am waiting for more surgery. Bang goes my driving license again. It keeps life interesting though. For all the tests an advances, cancer is still very much luck of the draw, with lots of variables, foreseeable and not.[Edit: For what it's worth, if you're over 50, maybe 55, ask for a PSA test. Yes it may throw up some false positives, but better that than a late diagnosis, on an individual basis].

author: tggzzz
author_rank: Super Contributor
timestamp: May 21, 2025, 06:28:20 pm
content: Quote from: rdenney on May 21, 2025, 06:00:41 pmThe treatment pathways have become sufficiently sophisticated that overtreatment is less likely than before. The does indeed push the boundary towards having a PSA test. However, I would still be more wary in the US than the UK, since there is an overt profit motive (in the UK any profit motive is more likely to be in terms of a CV than £).The recent influencer/wellness/alt-medicine sales people are a cause for concern.

author: tggzzz
author_rank: Super Contributor
timestamp: May 21, 2025, 06:37:37 pm
content: Quote from: Gyro on May 21, 2025, 06:11:28 pmMy commiserations; it never rains but it pours.I've come to the conclusion that I am going to die, and I'd prefer a cause that allows me to retain some control. (What else would an engineer say!) Hence stroke/quadriplegia is not preferred.There is an attitude - apparently adopted by some US doctors who see what happens to their patients - that once you reach 75 you should only allow yourself to be treated for minor curable ailments, e.g. antibiotics for infections. Contrariwise, for anything major, decline treatment and enjoy remaining life ticking off your bucket list.QuoteI tend to agree, subject to my points above and to the acceptability of treatment side effects.

author: Gyro
author_rank: Super Contributor
timestamp: May 21, 2025, 06:50:40 pm
content: Quote from: tggzzz on May 21, 2025, 06:37:37 pmThanks tggzzz. I've had a pretty lucky ride, 15 years since awake craniotomy and debulking (it's an infiltrating one, so not curable) and a year of chemo. with only slow infiltration. I got my license back after 7 years. I'm not planning on this being the end and I don't know if more chemo or radiotherapy will follow. Radiotherapy is my least preferred option due to the delicacy of the brain and later manifesting side effects. I don't think I would ever feel safe with asleep brain surgery either.Yes, I intend to die with my boots on and my decision making clear.

author: andy3055
author_rank: Super Contributor
timestamp: May 21, 2025, 07:00:37 pm
content: I am with Kaiser for health insurance. After 70, they don't do PSA test as it tends to give positive results for some wrong reasons (according to my primary doc). However, if necessary, they will do a full blood test on occasion.

author: jpanhalt
author_rank: Super Contributor
timestamp: May 21, 2025, 07:38:34 pm
content: @andy3055Early cancer at 70 is still curable. False positives are not a problem. They are by definition "false." True positives are a different story. Let's say you are 75 and have a positive PSA? When it's true, your life may have been saved for a few years more. If it's false, there not much harm to you, you still live longer , bu it costs Kaiser very little to repeat the test or do another study. What does Kaiser do for screening over 70 males for cancer? Or, is it just happy letting them die die because they are a cost center?

author: Bill158
author_rank: Regular Contributor
timestamp: May 21, 2025, 08:01:27 pm
content: My story:Around 1995 (I was 55) my GP did a DRE as part of my annual physical. He didn't like how my Prostate felt so he sent me to an Urologist along with ordering a PSA test. PSA was around 2 ng/ml, not too much to worry about but keep an eye on it, "watchful waiting". Urologist felt the same enlargement and wanted me to come back every year for another DRE and also have a PSA every year. In 2003 my PSA went up to 3, in 2004 3.3, in 2006 5.6 and then another PSA a few weeks later 6.0. So it started going up way too fast over just a few years. I wanted to see an Urologist urgenly and my PCP agreed and sent me to the Urologist (my health plan had changed and I was now on Medicare Part "C"). The Urologist wanted to do a Biopsy of the Prostate. I agreed and the result was a Gleason score of 8 out of 10. BTW the procedure is NOT the most fun I have ever had, but necessary! I chose radiation over removal of the Prostate after some research. The Urologist recommended removal by microsurgery which would be done through the naval. But it was my choice so he put 3 Gold Fiducials in the Prostate, again NOT fun, these are for alignment of the 3D radiation machine. Then I went to the Oncologist for the radiation treatments. My treatment was 2 rads (or whatever they call it now) per day for 37 days. This was done using the vary latest 3D machine which rotated around me at 90 degree intervals so as to radiate all around the Prostate. I had very little or no effects during the treatment. Then a PSA test a few months later showed my PSA at 0.1! I got annual PSA tests for the next few years and they all came back 0.0 or 0.1! Last one was in 2014. So now I am 85 and still kicking, well alive at any rate.As far as Biden, he should have been tested all along as part of his annual. I would bet that his PSA levels are out of sight. I wish him the best of luck.My point here is "take command of your health and insist on testing and whatever you feel is important". Don't let the doctors talk you out of anything.Bill

author: tszaboo
author_rank: Super Contributor
timestamp: May 21, 2025, 08:11:18 pm
content: Quote from: jpanhalt on May 21, 2025, 07:38:34 pmYes usually what happens after a false positive is just a visit by Dr. Pokey Finger PHD, in a blue glove (who knows, knows), which is a 1 minute exam.Everyone with the stories, please keep them coming. We need a reminder to take care of ourselves. I wish you good health.Quote from: Seekonk on May 21, 2025, 12:50:46 pmProbably forgot to take the test because all the dementia.But on more serious note, I don't know what's worse. If they knew of if, or they didn't. Not good either way, the credibility of that party is so dangerously low now.

author: jpanhalt
author_rank: Super Contributor
timestamp: May 21, 2025, 08:22:49 pm
content: Quote from: tggzzz on May 21, 2025, 06:28:20 pmYour view of American medicine seems very inaccurate. First, it is more complex than you seem to appreciate. Going to a government owned clinic is the last place I would go. Our VA medical system -- functionally similar to Britain's NHS, except you have to be a veteran -- used to be absolutely atrocious. It is still not comparable to our better sites. Second, working to improve your CV is not working to take care of patients. There are some instances where that may be the best choice , as in very rare diseases. But those occur rarely. Otherwise, if you are an ordinary, sick person, nothing publishable, not part of a study, at a CV-oriented place, you will get long wait times, messed up scheduling and procedures, messed up billing and usually treatment by trainees or even medical students.Some places, like Wills Eye Hospital (Philadelphia, PA, associated with Jefferson University) and Mayo Clinic (Rochester, MN, associated with University of Minnesota and its own medical school now) have achieved a good mix of academic and great clinical care. That is not the case with Johns Hopkins (Baltimore,MD) or many other university medical schools. Kaiser is not on my list of places I would go to either. It is not oriented to good patient care. Those places that have succeeded in getting a good mixture active research and clinical care have rewarded excellence in clinical practice. One's CV of publications at Mayo is less important than what they do clinically; although, those measures are not mutually exclusive. It used to be said that Mayo was rarely the first to do something and usually the first to do 1000 of something.When President Clinton and his wife, Hillary, visited Mayo, they were so impressed, she (or maybe he) said afterwards, "This is how medicine should be." Clinton then did the opposite. When I have a choice, I go to a large, private practice group with an academic affiliation. I also check the credentials of various physicians at the place and any physician who I will see.

author: tggzzz
author_rank: Super Contributor
timestamp: May 21, 2025, 08:39:54 pm
content: Quote from: Bill158 on May 21, 2025, 08:01:27 pmOr into anything.In the 1950s my father was severely deaf, and deafaids were extremely primitive.A surgeon offered him a new operation, a stapedectomy. The operation failed, and left him stone deaf in one ear. The surgeon wanted to try the operation on his other ear, but the family said no. Later, somehow, they worked out the surgeon was "practicing" to enhance his CV.20 years later my father tore his calf muscle skiing. The GP disbelieved him, and told him to do the standard test: rise up on your toes. He refused. The consultant told him that if he had done the test, he would have had permanent damage and walked with a limp.I had a similar experience later, when I snapped my achilles tendon (while showing my daughter how to use a springboard safely. Oh, the irony!) Refusing the test meant I avoided an operation.So, tests can damage you, don't blindly do what the medic says.

author: jpanhalt
author_rank: Super Contributor
timestamp: May 21, 2025, 08:49:28 pm
content: Quote from: tggzzz on May 21, 2025, 08:39:54 pmIsn't that contrary to your previously stated reason for preferring the NHS (CV-enhancement system) to America's somewhat capitalistic system?

author: tggzzz
author_rank: Super Contributor
timestamp: May 21, 2025, 09:16:48 pm
content: Quote from: jpanhalt on May 21, 2025, 08:49:28 pmPeople are people, the whole world over. Deal with it.Just because there are more incentives in one country doesn't mean there are zero in another.The medical profession 70 years ago was veryverydifferent. The NHS was less than a decade old, treatments were far less effective, and consequently there was a much greater reliance on patients believing the local deities would work wonders.

author: tggzzz
author_rank: Super Contributor
timestamp: May 21, 2025, 09:21:55 pm
content: Synchronicity.Just perceived an email from a local prostate support group which notes that the main UK PCa charity, Tackle, is..."The Tackle monthly briefing email, which many of you may receive, indicates that they are carrying out a survey intoovertreatment after diagnosisof prostate cancer. This is to assist in thenational debate around screening" (my emphasis)

author: pcprogrammer
author_rank: Super Contributor
timestamp: May 22, 2025, 06:39:23 am
content: For everyone on here who suffers from cancer, bon chance.My 2 cents here.I have like a bad faucet type of peeing. Sometimes it won't open quickly even though I feel pressure, and other times it is only drip drip, or intermittent and needs pushing to finish the process. A while back there was also pain during and after. This is going on for quite a while now and seems to be part of my chronic fatigue syndrome. The pain might have been a side effect of my medication and have not experienced it since a change in that medication.Based on the above I have regular blood testing including PSA which returns a value of 0.85 μg/L and according to the paper it should be less then 4, so no issue according to my doctor. It has been on this level for many years now.Also had several ultrasound checks of the urinal track and bladder which shows the normal enlargement of the prostate and nothing else.I do like to stay on top of things, not out of being scared, but to make sure that the symptoms I experience are not just written of on my ailment. So yes, for me a yearly exam of my blood and possibly other exams are undertaken.A bit of a horror story from a friend of ours. A bit over two years ago he was experiencing pain while urinating and finally he went to have it checked. His PSA was not to heavily elevated, but he still had severe prostate cancer with spread to the lymph nodes. Live expectations where not to high for this type of cancer. Only few made it past 5 years said the doctor. Treatment suggested was radiation of the prostate and hormone therapy to suppress the remains in the lymph nodes. This worked up to recently. His PSA went up again and it turns out that the same cancer has spread to his liver. Without treatment maybe 6 months to live. So now he is having chemotherapy and it looks like it is working. PSA is down again, but the cancer scare will remain part of his live.So there is no guarantee that you are free of cancer after some seemingly successful treatment.

author: wilfred
author_rank: Super Contributor
timestamp: May 22, 2025, 07:14:15 am
content: I encourage anyone to get tests done so you know what is normal for you. Even if there is nothing bothering you now. That way if your doctor needs to do tests for something specific they will have that baseline. There's lots of things, not just cancer that can be revealed early, and it can improve your chances. My doctor noted a drop in Iron levels and even during the peak of the Covid Delta phase here they got me into hospital straight away.You never know if you don't get the tests and what you don't know actually can kill you.If you do nothing else at least know your blood pressure. They don't call hypertension the silent killer for nothing. It can often be controlled quite easily.That's my 2 cents.

author: pcprogrammer
author_rank: Super Contributor
timestamp: May 22, 2025, 07:33:48 am
content: Quote from: wilfred on May 22, 2025, 07:14:15 amIndeed, also good to keep taps on that. For me it is a bit low blood pressure (hypotension) that is troubling me. Often in the range of 106/75 where 120/80 is normal for younger people. For me this results in episodes of dizziness when I get up to quickly. Not alarming though, according to my doctor. When it drops below 100/70 it is time to take action.Your health is a precious thing and life is better when it is up to par. Take good care of yourself is my advice and it does not have to be a drag to do. Watch what you eat, try to avoid stress as much as possible and take time for yourself.

author: Zero999
author_rank: Super Contributor
timestamp: May 22, 2025, 07:56:03 am
content: Quote from: pcprogrammer on May 22, 2025, 07:33:48 amThat's interesting, I've been told my blood pressure is fine, but I sometimes get dizzy when standing up too quickly. I put it down to dehydration, as it happens after intensive exercise, especially when it's warm.

author: pcprogrammer
author_rank: Super Contributor
timestamp: May 22, 2025, 07:59:54 am
content: Quote from: Zero999 on May 22, 2025, 07:56:03 amYour blood pressure can drop when dehydrated. One of the remedies for low blood pressure is to take in more fluids, preferably just water. Using more salt is another one, but to much salt brings other issues.As with everything balance is key.

author: EEVblog
author_rank: Unknown
timestamp: May 22, 2025, 08:00:49 am
content: Quote from: Zero999 on May 22, 2025, 07:56:03 amI get dizzy from spinning WAAAAY easier than I did when I was a kid (I have kids, so you spin a lot while playing). I've asked other people my age and they all say the say thing, yeah, your tolerance for spinning goes down as you get older.I have no blood pressure problems, it's an age related vestibular system thing.

author: chukin
author_rank: Contributor
timestamp: May 22, 2025, 08:11:40 am
content: @pcprogammer: I can recommend taking either silodosin or tamsulosin for prostate-related peeing problems. Been taking it for over a year and can go all night without getting up, as opposed to 2-4 times per night previously. Also flow is better. No significant side effects and quality of sleep much improved!PeterCheering thought of the day: you know you've hit old age when you have to starting taking a pill a day and you know that you'll have to take it for the rest if your (hopefully long!) life....

author: EEVblog
author_rank: Unknown
timestamp: May 22, 2025, 08:17:26 am
content: Quote from: chukin on May 22, 2025, 08:11:40 amThe only pills I take are my vitamins and minerals.https://www.youtube.com/shorts/-2mf1mqZVQ0

author: Zero999
author_rank: Super Contributor
timestamp: May 22, 2025, 08:24:27 am
content: Quote from: EEVblog on May 22, 2025, 08:00:49 amDizzy probably wasn't the correct term, I meant light-headed.And I've never been able to tolerate spinning. My dad once pushed me too fast on a roundabout and I was sick. I don't know if it's changed much with age.

author: tggzzz
author_rank: Super Contributor
timestamp: May 22, 2025, 08:30:07 am
content: Quote from: pcprogrammer on May 22, 2025, 06:39:23 amQuite right too. Symptoms need to be investigated.My father had a similar problem, and eventually "had a rebore", i.e. TURPS.https://www.nhs.uk/conditions/transurethral-resection-of-the-prostate-turp/QuoteAlways the case.Frequently the definition of "free" is "no symptoms after 5 years". The 5 years is, of course, merely a magic number - and should be treated as such.

author: tggzzz
author_rank: Super Contributor
timestamp: May 22, 2025, 08:34:08 am
content: Quote from: pcprogrammer on May 22, 2025, 07:59:54 amYes indeed.Presumably using more salt "solves" the problem by encouraging you to drink more fluid.Easiest quick check for dehydration: observe the colour of your urine stream.Oddly enough, too many "wellness influencers" forget to mention that, and push the pseudoscience that you should must 2l of water/day.

author: tggzzz
author_rank: Super Contributor
timestamp: May 22, 2025, 08:39:45 am
content: Quote from: Zero999 on May 22, 2025, 07:56:03 amThat symptom should be investigated, since it could be a heart problem and if you do blackout a fall might injure you.The first-line ECG check is non-intrusive and is done in my GP's surgery. Mine does show a "suboptimality" which I have to declare when getting travel insurance, but there's no point in taking any action until it causes me problems.

author: brucehoult
author_rank: Super Contributor
timestamp: May 22, 2025, 08:57:50 am
content: Quote from: tggzzz on May 22, 2025, 08:34:08 amNote that this changes radically if you take vitamin pills.Which is another overused thing. I have some different kinds that all say to take one a day, but I do more like once every week or two. I think it's the glucosamine that actually does have a very noticeable effect on eliminating twinges in hips etc, even at that level. The others are CoQ10 and a generic "Men's vitamins".

author: tggzzz
author_rank: Super Contributor
timestamp: May 22, 2025, 09:02:46 am
content: Quote from: brucehoult on May 22, 2025, 08:57:50 amOr beetrootDue to that, a doctor once insisted on checking my urine for bloodQuoteThere's a lot of money to be made flogging vitamins to the "worried well" brigade. OTOH, I'm prescribed one vitamin and some people need regular injections of B12.

author: pcprogrammer
author_rank: Super Contributor
timestamp: May 22, 2025, 09:13:47 am
content: Quote from: brucehoult on May 22, 2025, 08:57:50 amBe aware that there are two version of CoQ10. Ubiquinol and ubiquinone. The first one is easier to be absorbed by the body when you get older. It is what I started to take little over a month ago in combination with ginkgo biloba to see if it helps. So far no improvement detected.

author: Zero999
author_rank: Super Contributor
timestamp: May 22, 2025, 09:38:51 am
content: Quote from: tggzzz on May 22, 2025, 08:39:45 amI'm not worried, because it's mild (I don't black out) and it only happens when I'm hot and sweaty, after intensive exercise in warm weather.Orthostatic hypotension is a very common sign of dehydration. I just sit down, have a drink and perhaps a snack if I'm hungry and I feel better after my body has absorbed the fluid.https://www.mayoclinic.org/diseases-conditions/orthostatic-hypotension/symptoms-causes/syc-20352548

author: EEVblog
author_rank: Unknown
timestamp: May 22, 2025, 09:43:19 am
content: Quote from: brucehoult on May 22, 2025, 08:57:50 amNope, doesn't for me.I do pretty extreme levels of workout and I've been using the clear urine test for my pre-workout hydration level for 30 years. Hasn't change at all with vitamin supplements.And some would consider my level of vitamin supplementation as fairly extreme.

author: 5U4GB
author_rank: Super Contributor
timestamp: May 22, 2025, 09:46:53 am
content: Quote from: Zero999 on May 22, 2025, 07:56:03 amIt's also an age thing. By the time you're 70-80 you'll need to give yourself advance notice in writing every time you plan to stand up quickly.

author: watchmaker
author_rank: Unknown
timestamp: May 22, 2025, 11:16:23 am
content: Quote from: pcprogrammer on May 22, 2025, 06:39:23 amYep. I do all my care at Dartmouth Medical Center here in New Hampshire. Just asked my Physician (I do not use this term freely) who is also the Dept Chair of Internal Medicine about how Biden could not have had PSAs from Walter Reed. Turns out that over 69, given the usual slow progression of prostate cancer, that PSA levels increase after age 70 resulting in false positives leading to unneeded and painful biopsies, that in the USA the standard of care is no PSA after age 70 unless requested or for case specific reasons.Also, to check that those of us who were cured do not have a rogue cell that got away. So even though I am 72 my PSA levels are checked annually.I remember my first biopsy. The SOB insisted I could not possibly feel pain as I held back tears during the taking of 14 samples while on all fours. If I had the sense of my beagle, I would have turned around and destroyed his face. My second urologist at Johns Hopkins said the butcher violated standards by not stopping and rescheduling for sedation. The first guy even missed and the second revealed a small wart sized lesion. I elected to just have the prostate taken out and to be done with it. Now I have to take half a Viagra just so I do not pee on my toes. But I am very happy.Turns out, if I was 10 years older, they would have pushed me into radiological treatment. Again, a data based age treatment standard. Surgery is too risky after 75 and most men who have radiological based treatments die before the long term side effects of the radiological procedures catch up with them. This is why surgery is the recommended optiom before 70.And BTW, the surgery is far less intrusive and damaging than that of our fathers. No diapers and nerve damage is very rare.If you love your family, get the PSAs. If it suggests investigation, go to people who are bored to death by what you are presenting.

author: EEVblog
author_rank: Unknown
timestamp: May 23, 2025, 04:58:22 am
content: Quote from: watchmaker on May 22, 2025, 11:16:23 amYou mean like being the president of United freakin' States?They would have been testing his blood regularly anyway, so there is absolutely no way they weren't also testing for PSA. What they do this that info is another matter, but no way they weren't testing for it.

author: EEVblog
author_rank: Unknown
timestamp: May 23, 2025, 05:10:55 am
content: Trump called Adams personally:https://x.com/JackPosobiec/status/1925578278846230889

author: jpanhalt
author_rank: Super Contributor
timestamp: May 23, 2025, 05:54:19 am
content: @EEVBlogI tend to agree with you on that.Not every medical entity in the US follows the stop testing at 70 guideline. Here are MD Anderson Cancer Center recommendations:https://www.mdanderson.org/prevention-screening/get-screened/prostate-cancer-screening.htmlQuoteI go further. Not recommending PSA after 85 doesn't mean you shouldn't get it, unless you are already dead. It's more valuable than many of the other routine tests that are done and cheap.

author: tggzzz
author_rank: Super Contributor
timestamp: May 23, 2025, 07:04:18 am
content: Quote from: EEVblog on May 22, 2025, 09:43:19 amPresumably you are careful not to harm yourself with too much vitamin A and Fe. The latter is a traditional reason kids end up in A&E, and the former kills people eating some livers.Too much Ca has unfortunate side effects as well.

author: Zero999
author_rank: Super Contributor
timestamp: May 23, 2025, 07:12:41 am
content: Quote from: EEVblog on May 22, 2025, 09:43:19 amIt depends. I believe it's the B vitamins which are responsible for dark urine. It's also possible you over hydrate, leading to too dilute urine, but it's normal colour due to excessive vitamins.

author: NE666
author_rank: Frequent Contributor
timestamp: May 23, 2025, 08:25:38 am
content: Quote from: Zero999 on May 23, 2025, 07:12:41 amB vitamins tend towards the yellow or orange end of the 'urine spectrum', especially B2 (riboflavin). If you've ever taken "Berocca" brand tablets, you can't miss it, properly hydrated or not.

author: EEVblog
author_rank: Unknown
timestamp: May 23, 2025, 08:52:41 am
content: Quote from: tggzzz on May 23, 2025, 07:04:18 amI get the recommended daily intake of A. No Fe supplement.Ca not close to recommended.

author: tggzzz
author_rank: Super Contributor
timestamp: May 23, 2025, 09:25:36 am
content: Quote from: EEVblog on May 23, 2025, 08:52:41 amJust checked on Vitamin A; I'm surprised the margin between RDA and "best not to exceed" is so small.https://www.gov.uk/government/publications/sacn-review-of-dietary-advice-on-vitamin-aSummary advicehttps://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-a/Summary summary advice: easy to get (and exceed)from food aloneLinks from that summary page lead to Fe: 15mg/day women, but high dose leading to side effects is only 20mg/day!Other links include balanced information, stating there is insufficient evidence.

author: jpanhalt
author_rank: Super Contributor
timestamp: May 23, 2025, 09:39:15 am
content: Quote from: tggzzz on May 23, 2025, 09:25:36 amVitamin A excess toxicity is classic. Carnivores have the highest concentration in liver. Ago old advice is to never eat bear liver or any carnivore live. Beef and chicken liver are generally OK. Beef liver, onions, and bacon were a favorite in our house as were chicken livers and yellow rice.

author: watchmaker
author_rank: Unknown
timestamp: May 23, 2025, 12:35:45 pm
content: Quote from: EEVblog on May 23, 2025, 04:58:22 amDave,Thanks for all you do. I justrestudied your videos on "Noisy DSOs" and low amplitude probing. I am finally getting the hang of the use of DSOs over DuMonts.I do take your engineering lessons and statements as fact. But when it comes to medical opinions, I will trust that of an academic physician over yours every day.BTW, some time ago I looked for how to donate but was unsuccessful. I know you are not begging for support, but I believe money is a way to show appreciation. How do I do this?Regards,Dewey

author: nctnico
author_rank: Super Contributor
timestamp: May 23, 2025, 06:05:55 pm
content: Quote from: EEVblog on May 23, 2025, 04:58:22 amBut the thing is that from a certain age, cancer treatment is not going to bring much where it comes to quality of life anyway. When you are older, your body's healing abilities will also diminish so pulling through an extensive cancer treatment or surgery (*) is going to be a big issue. As prostate cancer typically progresses slowly and has few symptoms, it is better to leave it untreated at high ages. Hence testing becomes less relevant. Keep in mind we where all born terminally ill.* As an example: my grandfather underwent surgery around 80 years old and even though it was a relatively simple procedure (joint replacement), he needed 8 weeks to recover while younger people are back on their feet within a week or two.

author: SiliconWizard
author_rank: Super Contributor
timestamp: May 23, 2025, 06:35:42 pm
content: Quote from: nctnico on May 23, 2025, 06:05:55 pmTrue. Exception of course is if it's really debilitating; if there's an enlarged prostate to the point of having difficulties to urinate, that becomes a problem worth handling. If that's not the case and that's just visible on scans and blood markers with no annoying symptoms, indeed, treatment can do more harm than good at this age. Also, apparently most people past a certain age are thought to have some form of slow-growing cancer which does not actually have any significant impact on their life expectancy.

author: Analog Kid
author_rank: Super Contributor
timestamp: May 23, 2025, 06:38:48 pm
content: Quote from: Zero999 on May 22, 2025, 07:56:03 amHappens to me sometimes, fortunately rarely. (Otherwise in good health, knock on wood.)I attribute it to not having had enough breakfast that day.

author: jpanhalt
author_rank: Super Contributor
timestamp: May 23, 2025, 06:47:01 pm
content: @nctnicoThere is no question about the fragility of older people. A sequence often repeated is trivial accident > hospital > bed w/ restraints and/or discharge to temporary nursing home > pneumonia > death.The issue is knowledge and trying to catch the cancer early, not treating elderly with aggressive therapy. I don't know much about your health plan, except decades ago your physicians tried to go on strike and that was stamped out by the government. In every country, once an individual retires, they are a cost center for the health plan. In the US, it's a double whammy. They cost Social Security (a small pension) and Medicare, both of which were sold as insurance, but they are not. Premiums goes into general revenues. It's a ponzi scheme. Both are going broke due to political actions to buy votes and give benefits to those who have paid almost nothing.Women have a very strong lobby. Men do not. Our government decided testing men after 70 was not beneficial. Just like Dr. Fauci's lies about "follow the science," the science behind it is weak. MD Anderson (a preeminent US cancer center) disagrees. It is not conflicted like Medicare is. There is also an immeasurable value in knowing whether you have cancer or not before it is too late. Treatment of early prostate cancer in someone who is 75 or even 80 can prolong life. Not always, but sometimes. That should be a personal choice. It also contributes to your peace of mind. Wouldn't you like to know when and how you were going to die? I would. How do you put a price on that?

author: watchmaker
author_rank: Unknown
timestamp: May 23, 2025, 07:10:44 pm
content: I agree with all three of the above. There are many situations where one major surgery leads to a downward spiral. This is why recommend friends thatif they have choiceto have one gate keeper who gets to know their values; generally an internist. But that is becoming increasingly hard to do these days and the only other option I know is a life partner who will fight for you. And of course a living will and needed legal papers to represent your interest, although those are of limited value in some US states.It reaches a point where the expected recovery time becomes too much of a percentage of your expected remaining life span. Whether surgical, chemo or radiological.Maybe an opportunity for attorneys to specialize in fee based patient advocacy?

author: EEVblog
author_rank: Unknown
timestamp: May 23, 2025, 11:49:41 pm
content: Quote from: nctnico on May 23, 2025, 06:05:55 pmSure. He already had dementia and was feeble before he became president, anyone with any clue what so ever and who didn't watch curated news knew that.But there is no way they didn't run every possible test under the sun on the presidents blood. Absolutely no way.If my PSA started to spike drastically at near 80yo and I was already feeble, I probably wouldn't do a thing about it either.In the case of Scott Adams, he's only 67 (and PSA probably started to spike early 60's?) and is as sharp as a tack and also physically fit, so that's when you most certainly want to really think about doing something about it (and he did, but it's too late).

author: 5U4GB
author_rank: Super Contributor
timestamp: May 24, 2025, 08:19:31 am
content: Quote from: brucehoult on May 22, 2025, 08:57:50 amGlucosamine (and its frequent companion chondriotin) are a real pain of thing to take because for the vast majority of people they do nothing, but since it's such a long-term thing you can't readily tell whether you're one of the few that it helps. There have been medical tests run over periods of decades (e.g. the GAIT trial) where, at the end, the conclusion was still "we don't know whether this stuff works or not". Even the dosage, if there is one, is unknown, most tablets/capsules come in 1,000mg or 1,5000mg dosages not because that's a known effective dose but because that happened to be the amount that was used in various trials.Quote from: brucehoult on May 22, 2025, 08:57:50 amAh yes, vitamins B, E, and Er.

author: 5U4GB
author_rank: Super Contributor
timestamp: May 24, 2025, 08:22:47 am
content: Quote from: EEVblog on May 21, 2025, 10:22:46 amIt's the magic word "cancer" that has the effect. It's so bad that various medical associations have proposed renaming lower-risk cancers to something else without the word "cancer" in it to avoid the panic reaction that the word triggers. And that includes some types of prostate cancer, since that's the subject of this thread.

author: EEVblog
author_rank: Unknown
timestamp: May 24, 2025, 09:51:04 am
content: Quote from: 5U4GB on May 24, 2025, 08:22:47 amIt's the doctors that ultimately have to do whatever it is to you though, and if it's not appropriate to your condition it should be their duty to inform you to calm the F down. Not to mention your doctor in the first place.It's not like a surgeon is just going to lop out your prostate because you tell them to.On second thought, the horrible things being done to kids today, I'd believe anything is possible....

author: tggzzz
author_rank: Super Contributor
timestamp: May 24, 2025, 10:04:40 am
content: Quote from: EEVblog on May 23, 2025, 11:49:41 pmThe race does not always go to the fastest horse, but that's the way to bet.A very well publicised tragic example: Sir Chris Hoy has won 6 gold and 1 silver Olympic medals. He has stage 4 PCa with 2-4 years to live. At diagnosis he was 48.https://www.england.nhs.uk/2024/10/sir-chris-hoys-terminal-cancer-diagnosis-prompts-near-sevenfold-increase-for-prostate-cancer-advice/

author: tggzzz
author_rank: Super Contributor
timestamp: May 24, 2025, 10:10:04 am
content: Quote from: EEVblog on May 24, 2025, 09:51:04 amYes, but some people can't be calmed down and "want everything possible done". Others can't be geed up, and need to be persuaded. At the first meeting, they don't know which the patient is, so their "bedside manner" has to quickly work it out; not trivial.At my first meeting with the consultant, his first question was memorable: "do you know why you are here?". Presumably some people didn't or were in denial.

author: jpanhalt
author_rank: Super Contributor
timestamp: May 24, 2025, 10:30:39 am
content: Quote from: tggzzz on May 24, 2025, 10:10:04 amMaybe some patients don't, but that is a standard question for any physician and particularly specialists to ask. Trainees are told, "Never assume why a patient came to see you." It can be asked in many ways.

author: tggzzz
author_rank: Super Contributor
timestamp: May 24, 2025, 11:03:20 am
content: Quote from: jpanhalt on May 24, 2025, 10:30:39 amQuite possibly, and very sensibly. Based on a sample of zero, I wasn't expecting itI've seen several hospital tests, including for mental confusion, e.g. "what year did WW2 start?" to which the most accurate answer is 1919

author: jpanhalt
author_rank: Super Contributor
timestamp: May 24, 2025, 11:53:27 am
content: Exactly: Treaty of Versailles, signed on June 28, 1919.However, questions on orientation (place, person, time) are usually much easier.

author: andy3055
author_rank: Super Contributor
timestamp: May 24, 2025, 05:03:55 pm
content: Quote from: jpanhalt on May 21, 2025, 07:38:34 pmVery true. I was also thinking of that. But as you know all health insurance systems are cost centers. One good thing with Kaiser is that they do everything in-house, even the accounting. That leads to less arguments compared to horror stories we hear about health insurance companies screwing patients!I am sure if I insist, the doc will order the tests required.

author: TimFox
author_rank: Super Contributor
timestamp: May 24, 2025, 05:47:35 pm
content: Quote from: tggzzz on May 24, 2025, 11:03:20 amWhen presenting at an emergency room after a fall, I was asked similar questions, including "Who is the President?", but, being a smart-aleck, when they asked what happened on 9/11, I replied "Well, that's controversial.".

author: jpanhalt
author_rank: Super Contributor
timestamp: May 24, 2025, 06:06:20 pm
content: @TimFoxIf you were seen by a real person, you passed. If you were responding to some bot, I would refuse the test. What you are really looking for are weird answers, not just smart ass or answers based on ignorance.

author: Buriedcode
author_rank: Super Contributor
timestamp: May 24, 2025, 06:25:35 pm
content: With prostate cancer, most cases are slow growing and non-agreesive - so patients will most likely die from something else long before it metastasizes or becomes a problem. I get the word "cancer" has terrible implications, because of modern media, and soap operas portraying it always as either a death sentence, or "lose your hair get a bit sick then get the all clear" despite the fact that the majority of cases don't fall in to either of those catagories.The advice for many cases of prostate cancer is "watch and wait" because aggresive treatment does more harm than good - and patients really don't like hearing this because they feel something should be done. There is still this idea that one gets sick, or a disease, they see a doctor, the doctor gives medcine, you get better and its over, but many illnesses are just not like that - and not everything has a course of action that will lead to a complete cure. That idea - that there as always somethign that can be done to cure it - is pernicious, and many feel that ifd their doctors won't "do something" that it is up to them to treat themselves with all manner of snake oil or supplements that have no real effect on the outcome.It's a difficult situation for both patients and doctors because of the disconnect between what evidence shows is the best course of action, and what public perception of what that involves. There seems to be a modern thinking of "awareness" that somehow improves outcomes. It does in that it means more recognise symptoms and see their doctors, but it also has a negative impact that, some will be diagnosed much earlier, with a pathology that will not harm them, but they then have the anguish of living the rest of their life knowing they have cancer. It must be quick tricky to get the messaging right for public ads.

author: tggzzz
author_rank: Super Contributor
timestamp: May 24, 2025, 06:55:09 pm
content: Quote from: TimFox on May 24, 2025, 05:47:35 pmAt that time, Cheney.The famous quip was that George Bush 2 was one heartbeat from being president.

author: tggzzz
author_rank: Super Contributor
timestamp: May 24, 2025, 07:05:33 pm
content: Quote from: Buriedcode on May 24, 2025, 06:25:35 pmAdd in "doing a 10km run to fight cancer", the many wellness near-scams, and the subtext prevalent in some countries that if you don't get better then you didn't want/pray/etc enough.Then add in that early cancer diagnosis really does improve survival stats, even if the date of death is remains unchanged.

author: Buriedcode
author_rank: Super Contributor
timestamp: May 24, 2025, 07:17:41 pm
content: Quote from: tggzzz on May 24, 2025, 07:05:33 pmAhh yes the "virtue" part - I'm healthly, therefore I have done everything right and I deserve it - you're unhealthy, therefore you must have done something wrong, and deserve it. It's always the lucky wealthy who seem to have that attitude

author: jpanhalt
author_rank: Super Contributor
timestamp: May 24, 2025, 07:29:21 pm
content: Quote from: Buriedcode on May 24, 2025, 06:25:35 pmAnd, based on autopsy studies, many never realize they even have it.As for the big C, there are many that fall into a not usually serious category, but some of the public doesn't understand. Basal cell carcinoma (a skin cancer) is a cancer by definition. It does not metastasize. Squamous cell carcinoma is another skin cancer that can be more serious. I have had basal cell CA's since 1991. At that time, based on its location, I had Mohs surgery and even followup plastic surgery. In other locations, I treat them differently. Of course, you need to be sure what you are dealing with and see a dermatologist, if you aren't. It could be much more serious, like a melanoma.

author: tggzzz
author_rank: Super Contributor
timestamp: May 24, 2025, 07:36:46 pm
content: Quote from: Buriedcode on May 24, 2025, 07:17:41 pmPlus the arguably worse "why should I help someone who is unworthy (proven by their having a health problem)".That's soft eugenics, which will become a a dominant theme in the next decade.Call me Cassandra.

author: SteveThackery
author_rank: Super Contributor
timestamp: May 24, 2025, 08:06:42 pm
content: Quote from: Buriedcode on May 24, 2025, 06:25:35 pmI agree with this and the rest of your post, even though I didn’t quote it.The crux of the issue is thatsomeprostate cancers arenotlike that; theyareaggressive and fatal. Mine is like that. And this leads to the conundrum I mentioned earlier: things that are valid at a population level may not be valid at an individual level; the interests of the one may differ from, or even conflict with, the interests of the many.It isn't important to me that my cancer is unusual. Fifteen to twenty percent of prostate cancers are of the aggressive, life-limiting type at the point of diagnosis, but the figure is 100% for me. It would have been a lifesaverfor meto have enjoyed annual screening, but I can also see how weak the argument for universal screening actually is.Now that I'm a victim of the disease I've thought a lot about the fundamental disconnect between what would benefit us as individuals, and what would benefit us as members of a population.