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    Doctor Whom

    terry – an equally valid scenario to consider:

    In 2019, you are sitting in your comfy lounge chair at home. You have to get up frequently to change the continence pads because it gets wet and uncomfortable. You run out of pads but going up to the chemist is an effort as you have to clean up have a shower and change urine soaked pants to look presentable. If it’s after 5pm its a 5 k drive to any open chemist – by which time you will have leaked on your fresh pants already. If its after 9 pm then it’s a wait till morning.

    After the brachytherapy wasn’t all that successful you had a surgery. It was too hard to tell what the right thing to do was so you took the surgeons advice.

    You suffer from bowel problems and fluctuating hormones levels. Its too much trouble and too embarrassing to go out to social events much at all. So your social life has shrunk to the few people who visit. You’ve given up on the exercise you used to do bushwalking and playing golf because of the embarrassment.

    Your partner is understanding but things just aren’t the same sexually even though you both are caring and understanding and you were never that fixated on erections as the be all and end all..

    Your old mate rings up – he’s interstate with his new partner on a golfing holiday.

    He had a PSA about the same as yours 10 years ago but he did nothing. Not because he was informed but more because he said – “Bugger it –I’ll just live till I die”. You don’t see him much nowadays – he’s taken up with the local theatre group and goes along to Tai chi a couple of times a week. And he’s off overseas on a cheap flight at least once a year. He drinks a bit too much has a bit too much fun and other than being a bit overweight he’s happy and fit as a mallee bull

    You wonder if you’ve got much to look forward to.

    Just then the news comes on, some Professor is saying had a one in 50 chance of having had your life saved through having had your test. And a 49 in 50 chance of having undergone all that unnecessarily. What would you think? Those are the numbers for prostate cancer.

    What if it was one in 10 for having saved your life versus 9 in 10 being unnecessary?

    Or one in 3 verses 2 in 3 ?

    Where is the cut point for regret ?

    Now come back to today. What numbers from the above scenario would influence whether you do or don’t do the test. And you are scheduled to do the test tomorrow….

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  2. 2
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    Leo Braun

    • Doctor Whom, early detection of prostate cancer has always been a strong public health message, but does this end-up causing more harm than good? Apparently so, to the treasury coffers … http://blogs.crikey.com.au/croakey/2009/09/24/for-another-view-on-prostate-cancer-screening/#comment-830

    “Of course, having chemotherapy is a big ‘harm’ – and this is where it is so important for the research community to find out how to tell if one ‘small lump’ needs full bore treatment, or not”? http://blogs.crikey.com.au/croakey/2009/12/03/what-rights-do-cancer-patients-have/#comment-1615

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