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About The Siuslaw news. (Florence, Lane County, Or.) 1960-current | View Entire Issue (July 17, 2019)
SIUSLAW NEWS | WEDNESDAY, JULY 17, 2019 | 5A Community Voices Us TOO Florence — ‘To screen or not to screen,’ that is the question By Bob Horney Special to Siuslaw News I n Prostate cancer, we are dealing with the most fre- quently diagnosed non-skin cancer in men and the sec- ond-most frequent cause of male cancer death. So, what do we know about this dis- ease that a man might con- sider when contemplating screening? Except in rare cases, we know that prostate cancer usually begins long before it becomes symptomatic. We also know that prior to becoming symptomatic, there will usually come a point when the disease has progressed enough that it can be detected by a screen- ing test (PSA and/or DRE) while still contained within the prostate or within the prostate region. Most prostate cancers diagnosed at this stage will yield a five-year survival rate of nearly 100 percent; without screening, pros- tate cancer that will affect a man’s life will be diagnosed after symptoms develop, possibly having metasta- sized to distant parts of the body such as the lungs, liver or bones. Prostate cancer diag- nosed at this stage will yield a five-year survival rate of approximately 30 percent. Also, without screen- ing, it stands to reason that prostate cancer, which will never affect a man’s life, will not be diagnosed. Fortunately, most of the men with this low-risk prostate cancer diagnosed by screening will now be placed on Active Surveil- lance, postponing any ac- tive treatment unless or until cancer growth deems it necessary. We know the U.S. Preventive Services Task Force (USPSTF) and the American Academy of Family Physicians (AAFP) in 2012 advised men against being screened because it could lead to a diagno- sis and unnecessary treat- ment, potentially resulting in more harm (side effects) than benefit (lives saved). What do I hear from new- ly diagnosed prostate can- cer patients? The concern I hear is about saving their life. Rarely, if ever, do I hear concerns about possible side effects from treatment. Save my life — I’ll deal with whatever side effects I might get. Seeing that its 2012 rec- ommendation caused more men to be diagnosed with metastatic disease at their initial visit to a urologist, the USPSTF recommend- ed in 2018 that, “men ages 55-69 may choose to be screened.” The AAFP adopted the USPSTF 2012 recommen- dation but rejected the re- vised 2018 recommenda- tion. Instead, it put out its own recommendation: “Do not routinely screen for prostate cancer using a prostate-specific antigen (PSA) test or digital rectal exam. For men who desire a PSA screening, it should only be performed after engaging in shared deci- sion making. Screening for prostate cancer using PSA may prevent mortality from prostate cancer for a small number of men, while put- ting many men at risk for long-term harms, such as urinary incontinence and erectile dysfunction. “Whether this potential- ly small benefit in mortal- ity outweighs the potential harms is dependent on the values and preferences of individual men. There- fore, for men who express a desire for prostate cancer screening, it should only be performed following a discussion of the potential benefits and harms. Rou- tine screening for prostate cancer should not be done. PSA-based prostate cancer screening should not be performed in men over 70 years of age.” Representing the views of the AAFP, Drs. James Stev- ermer and Kenneth Find explained that “the AAFP believes that the net benefit [of PSA screening] does not justify routine screening or routinely offering shared decision making.” There is something wrong when the AAFP states (above) that screen- ing benefit vs. harm is “de- pendent on the values of each individual man” and then rejects routine shared decision making. What this means is that a man will have to express his desire for prostate cancer screening and then stand his ground. Unfortunately, some men have had to change doctors to get screened. As Oregon Urology In- stitute states (and Us TOO Florence concurs), “It is better to know than to not know.” Natural Perspective — Beware the bloom By Emily J. Uhrig, Ph.D Special to Siuslaw News We Oregonians know better than to take a warm summer’s day for grant- ed, and many of us see it as an opportunity to en- joy splashing about in our lakes and rivers. However, sunny days that warm the water to an agreeable tem- perature also create con- ditions ripe for blooms of cyanobacteria, which have serious health implications for people and animals alike. Cyanobacteria, more commonly known as blue- green algae, are a group of single-celled photosyn- thetic bacteria that, like plants, get their energy from sunlight. They occur naturally in diverse envi- ronments worldwide and, at around 3.5 billion years old, their ancestors are some of the oldest known fossils. In some cases, cy- anobacteria are beneficial for the environment, and they have positive uses in agriculture. For instance, their abil- ity to process atmospher- ic nitrogen helps plant growth, and cyanobacteria are applied to certain crops as bio-fertilizer. They can also be used to clean the environment by degrading pesticides and oil spills. However, under certain conditions, cyanobacterial growth increases dramat- ically and these tiny or- ganisms proliferate into an immense bloom visible in the water as mats of scum or foam. The danger of a cya- nobacterial bloom comes from toxins that some spe- cies produce. The purpose of these cyanotoxins is not fully understood, but they may be defense mecha- nisms to help the bacteria avoid being eaten. The toxins are potent and can be more deadly than cyanide or even co- bra venom. Just touching a bloom can cause skin irritation while ingesting water containing cyano- toxins, depending on the specific toxin, may affect the liver or nervous sys- tem and can be fatal to hu- mans, pets and wildlife. Dogs playing in the wa- ter are especially at risk and a number of canine fatalities linked to cyano- toxins have been reported in Oregon. Warm, slower-moving, nutrient-rich waters — conditions common in Or- egon during the summer — are especially prone to cyanobacterial blooms. Several lakes near Flor- ence have been previously cited as areas of concern for blooms and the South Umpqua River is under a permanent recreational use health advisory. Any- one heading out for a day at the lake or river should be aware that not all waters are monitored and lack of an advisory does not mean there is no risk. Cyanobacterial blooms come in a variety of colors and it’s not possible to tell toxicity by appearance, so steer clear of any bloom. More information at www. healthoregon.org/hab. (541)997-6000 www.RealEstateFlorence.com Need more space? Skip the online search and sign up for our HomeFinder email alerts to receive rapid updates on new listings in your area. HomeFinder will also deliver instant price updates, complete listing details, and interactive maps with satellite images. NEW LISTING Large enclosed storage room with slider out to concrete patio. All vinyl double paned windows. Large corner lot backs up to creek & wooded area. 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