Connect
← Return to The arbitrary economics of life and death
Discussion
The arbitrary economics of life and death
Prostate Cancer | Last Active: Apr 16 3:21pm | Replies (30)Comment receiving replies
But doesn’t proven science always become dogma? Don’t positive results time after time validate the thesis, which then becomes the proof?
I do not disagree at all that we all have peculiarities, quirks, genetic flaws which may alter our treatment or require ‘out of the box’ solutions.
But we must return to the realities of your healthcare system: PSMA PET and genetic testing cost money; enough money, in fact, that it could possibly be used to treat an additional patient or two with a different malady/injury.
So I think you should be raising your fist to THAT, not dogma.
Phil
Replies to "But doesn’t proven science always become dogma? Don’t positive results time after time validate the thesis,..."
Proven science applies to statistics. I am not a statistic. Proven science dictates that the treatment plan I am on works in 85% of patients. Where does this leave the narrative of tailored approaches for each particular tumor? Dogma is applied because it affords industrialized care. Do I benefit from it? I really don't know, because the local dogma police doesn't allow me to discuss options or strategies. All for the sake of Dogma, you understand... So I do not buy your argument
Connect
I had a talk with my oncologist (also in Ontario) about this yesterday at our quarterly appointment. He was a resident at Harvard Medical School before returning to Canada, so he's quite familiar with PSMA PET, even though it became available in Canada only in 2022 when the makers of the radioactive agent finally bothered to get it approved here.
He knows he can talk frankly with me — which I appreciate — and he said the biggest challenge with PSMA PET is that the field doesn't know yet exactly what to do with the results. By that, he doesn't mean that they're ignorant of the latest treatment options, but (I think) that the body of research isn't there yet to establish whether they're over-/under-treating based on the more-sensitive results that PSMA PET provides over CT, MRI, and/or bone scan.
That makes sense to me. It's the same problem they faced a few decades ago when PSA screening first became available, and they were way overtreating people based on small PSA rises "just to be safe," because they didn't have other risk-assessment tools and best-practices established yet.
PSMA PET scans are available at my Cancer Centre, but his advice is to wait until my PSA starts rising above 0 before getting one, because then the treatment options will be clearer if the scan shows some potential tiny positive results. As long as my PSA is 0 on the ultrasensitive test, nothing's growing, so leave well enough alone. YMMV.