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About The Siuslaw news. (Florence, Lane County, Or.) 1960-current | View Entire Issue (June 20, 2018)
SIUSLAW NEWS | WEDNESDAY, JUNE 20, 2018 | 7A Siuslaw News Community Voices Natural Perspective — By Emily J. Uhrig, Ph.D Special to Siuslaw News W ith Father’s Day in June, it’s time to celebrate dads of all sorts. For many animals, males have no active role in rais- ing offspring; in many cases, the young never even set eyes on their father. However, paternal care is not limited to humans. If asked to name an attentive ani- mal father, most folks would likely suggest bird species in which both parents tend the nest and feed the growing young. However, fatherly care can be seen in some unexpected indi- viduals, including certain insects. In general, insects are not Us TOO Florence — Bob Horney Special to Siuslaw News A s we sat down with Dr. Mehlhaff at our May 8 Us TOO Florence meeting, we had the opportunity to review the final version of the 2018 U.S. Preventive Services Task Force (USPSTF) recommendation on prostate cancer screening. The new recommendation supports an individualized approach to screening, based on physi- cian-patient discussions about the potential harms and bene- Go bug your father often associated with care by either parent. For many species, eggs are laid and the parents sim- ply move on with their lives, but a number of insects do provide continuing care for their off- spring. For the giant water bug, these parental duties fall exclu- sively to the male. As their name implies, giant water bugs are quite large, some- times over 2 inches in length. They live in freshwater ponds and lakes where they are preda- tors of other insects and even By Barry Sommer “S tar light, star bright / The first star I see fits of screening and letting the patient make the final decision based on his values and prefer- ences. It only applies to men ages 55 to 69 without symptoms or a previous diagnosis of prostate cancer. It has no special guide- lines for men at increased risk due to race or family history of prostate cancer. The USPSTF continues to recommend against PSA-based screening for prostate cancer in men age 70 years and older. You may recall that in 2012, the USPSTF recommendation relieved men of any deci- sion-making. The USPSTF sim- ply eliminated routine PSA screening for all men, regard- less of age. And, since the American Academy of Family Physicians (AAFP) adopted that recommendation, the elim- ination of most PSA screening happened overnight. All of a sudden, I had men tonight / I wish I may, I wish I might / Have the wish I wish tonight.” Where were you when you first heard or said that sing- song wish? It may seem silly, it’s just a childhood thing to keep the young’uns’ attention and give them another rhyme to mem- orize. Yet after we grow out of youth, there are few of us who can look skyward at night and not hear it in our heads. Too old to indulge in childish rhymes? Naw, you’re never too old as long as you can remem- ber what it’s like to be a child. Readers Choice Voted #1 Realtor Let Paul show you a new car or truck. Stop by today! 2150 Hwy. 101 • Florence (541) 997-3475 • 1-800-348-3475 are attached to aquatic vegeta- tion, but for others they are deposited directly onto the back of the male who will carry them until they hatch. Males defend their eggs from predators, including female giant water bugs. They also carry out various behaviors, such as underwater push-ups, to ensure the eggs are well-aerated and may assist off- spring with hatching. Without the males’ efforts, the eggs will not survive. The males’ parental invest- ments also come with costs. Egg masses are heavy, perhaps twice the weight of the male, which slows him down — decreasing his hunting efficiency and mak- ing him more vulnerable to predators. These are risks the male must take, however, if he is to see his offspring succeed. So, if you’re enjoying freshwa- ter activities for Father’s Day, keep an eye out for the giant water bug. His bite can be ago- nizing, but it may be just another father looking out for his kids. Behind the headlines telling me their doctor told them, “We don’t do that test anymore.” With the new guidelines, men who want the test should get it. That will be one step in the right direction. The USPSTF’s intent was to prevent men from being diag- nosed, treated and harmed from an indolent prostate can- cer that would never have threatened their lives. The Task Force determined the substan- tial harms of treatment, such as incontinence and/or impo- tence, far outweighed the limit- ed benefits of lives saved from early detection. As the USPSTF released its 2012 recommendation, dire warnings were sounded by urology experts and others that eliminating routine PSA screen- ing would lead to a reversal of the advancements in prostate cancer detection, treatment and survival rates made in the last Notes from the Siltcoos — Special to Siuslaw News small fish and frogs, which they catch using their strong forelegs as pincers. They stab their prey with a sharp beak-like structure to inject digestive chemicals that dissolve the victim from the inside. The bugs’ venom is not lethal for humans, but results in an excruciatingly painful bite. When it comes to reproduc- tion, the male carries much of the burden, often quite literally. After mating, the female depos- its fertilized eggs onto a solid surface. For some species, eggs several decades. So, what actually happened following the 2012 recommen- dation? As predicted, there was a significant reduction in men being screening. More men (at the time of their diagnosis) had higher-grade, more invasive prostate cancer with increases in positive surgical margin rates, tumor volume, and lymph node involvement. Also, at time of diagnosis, we have these fol- lowing findings, each being sta- tistically significant: 1. The median PSA level increased from 5.1 ng/ml to 5.8 ng/ml; 2. Mean age also increased from 60.8 years to 62 years; 3. As feared, the proportion of low-risk 3+3 Gleason cancers decreased from 30.2 percent to 17.1 percent; 4. In contrast, the incidence of high-grade Gleason 8+ pros- tate cancers increased from 8.4 percent prior to the recommen- dations to 13.5 percent follow- ing the recommendations; 5. One-year biochemical recurrence (BCR) rose from 6.2 percent to 17.5 percent. There is no good news in the above data. There is nothing there convincing me that elimi- nating prostate cancer screen- ing reduced the harms of screening. Instead, the data points to a far greater harm — more men being diagnosed with advanced, incurable pros- tate cancer. The question now is… How long will it take to turn things around in the primary care set- ting now that men are supposed to be the decision-makers? Anita D. Misra-Hebert, MD, MPH, and Michael W. Kattan, PhD, of the Cleveland Clinic note there are obstacles in doing so. “What the updated USPSTF recommendations for prostate cancer screening are asking of physicians is to take time to pause, explain what is currently known, understand patient preferences, and make the screening decision together,” they explained. “It is clear that these types of conversations are a necessity to deliver optimal patient care even while there does not appear to be enough time, or any specific incentives tied to engaging in these dis- cussions.” Looking at it that way, I have a suggestion: Join us at an Us TOO Florence meeting where you can talk with prostate can- cer survivors who have taken different paths along their prostate cancer journeys (based on their personal values and preferences) and the urol- ogists who do engage in time-consuming, patient-cen- tered decision-making. Call me at 541-999-4239 if you need meeting times and places. a dome which surrounded the earth. Remember, we used to be the center of the universe with all things revolving around us, until that heretic Galileo decided to look at the sky with his telescope and declare that we were not the center of the universe. With the advances in optics and the computer we can now look deep into the eyes of the universe. What has been revealed is nothing short of mind-bending. The Hubble Space Telescope has opened up the universe to such an extent that with the naked eye we can now look at all those pinpoints of light and understand them as portals to the past. The constellations that we all know are more than a bunch of stars that form a pattern; they house light-years worth of secrets as well as the keys to unlock those secrets. Billions and bil- lions of galaxies, stars, novas, white dwarfs, red giants, gas clusters and dust clouds all add to the totality of that ambient glow we see each night. With the advent of the Hubble we are able to see into the farthest reaches of the past, looking at what amounts to the beginning of the uni- verse. What were just spar- kling lights in the night sky with names like Orion, the Big Dipper, Ursa Minor, Andromeda, Vulpecula and Cygnus are now space/time gates, each one distanced by our perception of time as well as measured miles. This nightly glory is more intense if one allows for the eye and brain to adapt to the Purkinje Effect, named after the world famous Czechoslovakian anatomist Jan Evangelista Purkyně (but you knew that already, right?). It describes how our eye shifts toward blue as the light level decreases. This physiological response has also been described as dark adaptation, but the end result is our ability to see many more stars with greater clarity than if we just walked out of our well-lit house and looked skyward. I have experienced this firsthand when I wake at 3: a.m. and go outside for a breath of air. Since I have been in complete dark (asleep) for hours, the stars and sky are much brighter and more detailed. And one night, when I saw the Milky Way as a band of glowing cloudiness from hori- zon to horizon, I really felt the scale of my existence. Then I went back to bed. No sense wasting perfectly good sleep time gazing at the stars for too long, they’ll be there tomor- row night. Drifting off, I remembered this ancient Arabic proverb: “My lover asks me, ‘What is the difference between me and the sky?’ / The difference, my love, is that when you laugh, / I forget about the sky.” Keep looking up. And laughing. And loving. Pinpoints As I grew up in a large urban jungle, I did not have the opportunity to lay on my back gazing up at the heavens and marvel at the pinpoints of light that filled the night sky. My childlike wonder had been stunted by all the light pollu- tion emanating from millions of cars, homes and billboards that crowded my hometown’s sky. To see the endless sky and stars, one had to travel many miles to the east, out to the desert or up into the moun- tains to the pristine heights where skylight predominates. Like our ancient ancestors who have gazed at the night sky since the beginning of time, I too have wondered; will the sun come back tomor- row, and do I have to sacrifice a goat to make it happen? Night is scary with all sorts of dangers hidden in shadow and any manner of creature, whether terrestrial or celestial, abound in both our dreams and just beyond our sight. There are monsters in the dark — but with the coming of day they slink back to their lairs and we sigh a breath of relief. The stars and their ambient light may not be bright enough to keep the monsters at bay, but it is sufficient to allow us to peer into the past. We gaze skyward and see what is unseeable. We can watch the past unfold right before our eyes because the universe is a time machine. Think about this for a moment; when we see the light of the sun we are seeing it nine minutes after it was created. Thus the sunlight we bathe in is from the past. I know, weird and wonderful are the things that inhabit the celestial world, the space/time continuum being one of the more unique “rabbit holes” one can travel down. Our ancestors believed the stars in the sky were just points of light on the inside of