Joe Ferguson forever

if following the facts makes me a good guy, then I am. I was adequately compensated for that already. No head pat needed.

sounds like you approved of vance saying people were eating dogs and cats in Ohio, only to later admit he lied.

nope. you're dim if you pretend to know when or if a psa was done or that it was positive just because you want to. the test is not great. i've repeatedly shown that. not a loophole. a fact. it is absolutely possible that a psa was done a year ago and was negative. I posted a link that showed 15% of false neg psa's are in patients with aggressive cancers. not a loophole, a fact. and yes, by now we are all well aware of the hate maga's have for science.

stupid people should not do science or medicine. This is from The American cancer society site and is the currently used staging system IVA Any T, N1, M0 Any Grade Group Any PSA The tumor might or might not be growing into tissues near the prostate [any T]. The cancer has spread to nearby lymph nodes [N1] but has not spread elsewhere in the body [M0]. The Grade Group can be any value, and the PSA can be any value. IVB Any T, any N, M1 Any Grade Group Any PSA The cancer might or might not be growing into tissues near the prostate [any T] and might or might not have spread to nearby lymph nodes [any N]. It has spread to other parts of the body, such as distant lymph nodes, bones, or other organs [M1]. The Grade Group can be any value, and the PSA can be any value. as you can see, stage 4 is primarily defined by mets and lymph nodes. tumor size (T) does not define stage 4. The tumor can be any size. additionally, a large tumor can still be felt on rectal exam as a nodule.

My doctor and I followed the guidelines and found cancer. It was the right thing to do. Now we are doing active surveillance which is also the right thing to do. Re the specificity and sensitivity of tests, here's yet another quote from a 2024 article in a Family Practice journal (primary care docs do the vast majority of testing and interpretation) Although PSA testing has been used to screen for prostate cancer since 1987, there is no consensus on which threshold should warrant a prostate biopsy. The most commonly used threshold of more than 4.0 ng per mL (4.0 μg per L) has an approximately 70% false-positive rate. Lowering the threshold to more than 2.5 ng per mL (2.5 μg per L) increases the false-positive rate to 80%.8 Using a biopsy threshold of more than 4.0 ng per mL, the PSA test has an overall sensitivity of 72%, specificity of 93%, and positive predictive value of 25%.9 As many as 15% of men with a PSA level less than 4.0 ng per mL will have prostate cancer on biopsy, and 15% of those cancers are high grade (which is a possibility in Biden's case).10 Benign prostatic processes, such as hypertrophy or infection, can also cause PSA elevations. Many strategies have been suggested to improve the diagnostic performance of the PSA test, such as free PSA, PSA velocity, and PSA density. However, none of these strategies has been evaluated in an RCT. It's a hugely flawed test but still valuable in the appropriate population. You're dim.

Maybe. Maybe not if the white house doc appropriately feels a psa in an 82yo has more risks than benefits.. Either way, there's a decent chance it wasn't picked up by the test if it was done. again, sensitivity is low.

I think it would be reasonable to raise the threshold for positive psa in the older population if they desired to be tested. The attending doc can also offer serial psa's No one will stop you from getting the test over 70 but your doc willl almost certainly rec against it.

I am an MD but not a urologist. I've educated myself on it recently when my psa came back high. MRI is the follow up test. Then a bx if mai is positive. This is the up to date protocol And screening (all psa tests are screening in patients without known cancer) is not recommended in men over 70 by any of the organizations that make recs. Because the very real risk of overtreatin g and especially over biopsying. same reason for the high threshold for psa positivity... Re catching it early, obviously that gives a better prognosis but at 82 with this extremely aggressive grade (not stage- there are 4 stages, the forth being distant metastasis), my feeling is his prognosis is poor. I read 5 year survival is about 40% (mine is over 99% to0 show you the difference in grade and gleason scores) There are 9 grades based on cellular microscopic exam of biopsy tissue by a pathologist.

they can lower the threshold for a "positive"{ test but that lowers the specificity (more false positives) which would lead to many unnecessary biopsies (I just had 13 donefor an extremely low grade cancer that5 will likely never be of any problem. but it's the trend of psa that is most useful. I'm ordered every 6 month psa's for the rest of my life.

a study of 1.! Sensitivity= true positives/true positives +false negative. for psa it's 20% at the widely used threshold on 4ng/ml so, even if a psa done, there's an 80% chance a cancer will be missed within a population, at least in the study I posted. It's a crappy test. Always has been.

there is EVERY chance. Read the most respected guidelines. there's are similar. from US preventative task force Men aged 55 to 69 yearsFor men aged 55 to 69 years, the decision to undergo periodic prostate-specific antigen (PSA)-based screening for prostate cancer should be an individual one. Before deciding whether to be screened, men should have an opportunity to discuss the potential benefits and harms of screening with their clinician and to incorporate their values and preferences in the decision. Screening offers a small potential benefit of reducing the chance of death from prostate cancer in some men. However, many men will experience potential harms of screening, including false-positive results that require additional testing and possible prostate biopsy; overdiagnosis and overtreatment; and treatment complications, such as incontinence and erectile dysfunction. In determining whether this service is appropriate in individual cases, patients and clinicians should consider the balance of benefits and harms on the basis of family history, race/ethnicity, comorbid medical conditions, patient values about the benefits and harms of screening and treatment-specific outcomes, and other health needs. Clinicians should not screen men who do not express a preference for screening.C Men 70 years and olderThe USPSTF recommends against PSA-based screening for prostate cancer in men 70 years and older.D

What is not true? Specifically? I quoted experts from Dana Farber, Stanford and Johns Hopkins? And you know better because you have prostate issue? Here's another nice tidbit. Please support your contention and specify what I wrote that was incorrect. from arch Urology In this article we explain findings from the Prostate Cancer Prevention Trial (PCPT) concerning the operating characteristics of PSA for biopsy-detectable prostate cancer, with special emphasis on a subpopulation of men with PSA less than 4 ng/ml, what is often regarded as the "normal" level of PSA in healthy men. The PCPT enrolled 18,882 healthy men 55 years of age or older, with a PSA value less than 3 ng/mL and a normal digital rectal exam (DRE); 9,459 of these men were randomized to the placebo arm and 9,423 to the finasteride arm In this report we summarize the operating characteristics of PSA only for the placebo arm of the PCPT; operating characteristics of PSA on the finasteride arm are more complicated to assess since finasteride approximately halves the PSA value and will be reported only briefly. In our first analysis, we focused on a group of 2,950 men on the placebo arm who had had an end-of-study biopsy and a normal DRE and PSA < 4 ng/mL for all 7 years of the study. For prostate cancer, the standard PSA cut-off of 4 ng/mL has low sensitivity: with this cut-off only 20.5% of the prostate cancer cases test positive-nearly 80% of prostate cancer cases are missed. The specificity at this cut-off is high (93.6%) meaning only 6.2% of men who do not have prostate cancer falsely test positive. Lowering the PSA threshold for screening increases detection of aggressive cancer at an earlier stage, but has the unavoidable tradeoff of increased detection of the biologically irrelevant cancers.

No. He may not have had a psa since that is actually against guidelines act 82. Even if he did, psa is a notably poor test. There are signing numbers of false positives and negatives. It's part of the reason why screening is controversial. But the vast majority off of 80+yo that get prostate cancer will die of something else. Biden sadly probably will not. “One of the reasons that you don’t want to screen older men is they’re so likely to have prostate cancer, even though it’s that benign-ish prostate cancer that’s never going to kill them,” said Otis Brawley, a medical oncologist at Johns Hopkins University who treats patients with metastatic prostate cancer. “I’ve seen an awful lot of guys have a lot of mental torment and a lot of physical torment because they were diagnosed with a prostate cancer that all the doctors knew was a cancer that was never going to bother them if It was left alone,” Brawley said. President Trump had his PSA levels tested in April, according to the White House. They were normal. Speaking to reporters at the White House on Monday afternoon, Trump questioned whether Biden was tested, and why the cancer wasn’t caught sooner. Behfar Ehdaie, a urological surgeon at Memorial Sloan Kettering Cancer Center in New York, said while it’s difficult to provide an accurate assessment of Biden’s prognosis, men typically are not screened for prostate cancer after the age of 70, unless they show symptoms. The public summary of his visit listed several tests doctors performed, but not a prostate-specific antigen (PSA) test. That’s not surprising, said Geoffrey Sonn, an associate professor of urology at Stanford University School of Medicine. “Really, there’s not many people out there that will advocate for continuing aggressive PSA screening for men in their 80s,” he said. “In retrospect, I think that it’s likely that if he had continued screening against pretty much all guidelines, that they probably would have found this earlier.” Current cancer screening guidelines are complicated, and Biden’s case echoes a tension; it’s best if the cancer is caught early, but there needs to be a balance between early detection and overtreatment.

https://thehill.com/policy/healthcare/5308413-prostate-cancer-screening-biden/ Biden’s diagnosis is serious, and while treatable, it can’t be cured. Prostate cancer experts said it’s unclear how long Biden has had cancer. Even if he was screened regularly in recent years, they said it’s not uncommon for cancer to develop without notable symptoms. “Cancer doesn’t necessarily follow a rule book. It’s possible that this came out of the blue, because cancer can do that,” said Alicia Morgans, a prostate cancer specialist at the Dana-Farber Cancer Institute, and board member of the advocacy group ZERO Prostate Cancer. The public summary of his visit listed several tests doctors performed, but not a prostate-specific antigen (PSA) test. That’s not surprising, said Geoffrey Sonn, an associate professor of urology at Stanford University School of Medicine. “Really, there’s not many people out there that will advocate for continuing aggressive PSA screening for men in their 80s,” he said. “In retrospect, I think that it’s likely that if he had continued screening against pretty much all guidelines, that they probably would have found this earlier.” Current cancer screening guidelines are complicated, and Biden’s case echoes a tension; it’s best if the cancer is caught early, but there needs to be a balance between early detection and overtreatment. Doctors not involved in Biden’s care said they did not see any signs of a missed diagnosis. “Nothing about his story sounds to me as if there’s been a cover-up or a delay, or anything that is untoward,” said Morgans. “It really sounds like an unfortunate case of prostate cancer diagnosed just a hair too late to cure in a man who also happened to be the President of the United States very recently, and now has a very real-world problem that he and his family have to tackle.”

not seen that. even in blue areas. but many of those are college towns. What are they selling? VW beetles?

routine PSA screening isn't recommended after age 70, partly because it's so prevalent. Partly because per population health measures it doesn't change mortality significantly. If you did post mortem ex's on all 100 yo would see almost 100% positives. Over 80, they're much more likely to die from something else. Biden is an exception but screening would likely not change anything, even in his case. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/prostate-cancer-screening. USPTFS guideline are adopted by medicare for reimbursement, or at least they were. Other recs are similar: The American Academy of Family Physicians39 and the Canadian Task Force on Preventive Health Care40 recommend against PSA-based screening for prostate cancer. The American College of Physicians41 recommends that clinicians discuss the benefits and harms of screening with men aged 50 to 69 years and only recommends screening for men who prioritize screening and have a life expectancy of more than 10 to 15 years. The American Urological Association42 recommends that men aged 55 to 69 years with a life expectancy of more than 10 to 15 years be informed of the benefits and harms of screening and engage in shared decision making with their clinicians, taking into account each man’s values and preferences. It notes that to reduce the harms of screening, the screening interval should be 2 or more years. The American Urological Association also notes that decisions about screening, including potentially starting screening before age 55 years, should be individual ones for African American men and men with a family history of prostate cancer. The American Cancer Society43 adopted detailed screening recommendations in 2016 that highlight the importance of shared decision making and the need for informed discussion of the uncertainties, risks, and potential benefits of screening. It recommends conversations about screening beginning at age 50 years and earlier for African American men and men with a father or brother with a history of prostate cancer before age 65 years. there is no stage 9, but if there were bleach would surely cure it.

yes, a little knowledge is a dangerous thing. Still, good to inject some reality into this. Odds are he'll be dead within a year. And it will be painful And maga's are all about a cover up. If they had caught it before it metastasized, his prognosis would be better (but still not good).

no, there isn't. Gleason score is the cellular type on biopsy. He's has Gleason 9 out of 10. He'd be dead if he had this a year ago or at a minimum in incredible pain from bone mets. Stage 4 just means mets. PSA trajectory is most important. Absolute PSA is less important. We don't know the last time that was checked or what is was. Regardless: GLEASON 9. LOOK IT UP.

yes https://finance.yahoo.com/news/citi-ceo-something-deeper-is-going-on-in-financial-markets-right-now-164730586.html "We are entering a new phase of globalization — one less defined by cooperation, and more by strategic self-interest," Fraser wrote. "Long-held assumptions are being challenged, not just by tariff announcements but by a deeper confidence shock. The near-term impact is already being felt, and the long-term trajectory is being rewritten in real time." Fraser said the markets are signaling a "shift" by moving to price greater risks into assets. "If you're looking to markets for clarity, you might be a tad disappointed," Fraser wrote. "But if you're looking for signals, they're everywhere. Treasury yields rose even as equity markets wobbled. The U.S. dollar, typically a safe haven, has weakened at moments when it used to rally." "That tells us something deeper is going on," she continued. "Investors aren't just pricing near-term risks; they're reevaluating the credibility of long-held certainties. It's showing up in how capital moves. Pensions and asset managers are tilting more towards Japan, India and parts of Europe. Hedge funds are being selective and didn't chase the April equity bounce. Sovereign wealth funds are diversifying more aggressively. Hedging against the dollar is now at levels we haven't seen in years."

the times, they are a changing https://www.dailymail.co.uk/yourmoney/article-14707641/Target-employee-exposes-tariff-price-hike-popular-items.html

cool. so do you think those cartoons are appropriate? I've never seen something similar from liberals. In North Georgia it's good advertising I guess.

So much for a quick peaceful end to the war. trump is putin's beech https://www.cnn.com/2025/05/19/europe/analysis-putin-trump-phone-call-ukraine-latam-intl For the best part of three years of war, Russia’s state media has been lecturing its audience they are not only in conflict with Ukraine, but also with all of NATO, including the United States. The presidency of Trump has created a small window in which the Kremlin might talk its way into a better position, or even alleviate the pain of some Western sanctions. But it does not change the central calculation or message of the Kremlin: this is an existential war, about re-establishing their pre-eminence in their near abroad. So much pain and loss has been inflicted on the Russian people through staggering war casualties that delivering middling to poor results might significantly limit the longevity of Russia’s leadership. This isn’t a war they can be seen to have lost.

perhaps we should both move to Austin https://www.southernliving.com/news/keep-austin-weird-history Nah, you'd hate it and I'm happy right here.

so you want an echo chamber for maga's.... so one of the houses we visited in Georgia was that of a contractor. He had a big rock truck with his company name and a cartoon of trump with 2 middle fingers up. another with trump pissing on a caption that said "liberals" . I didn't get into it with him. No point. This is what MAGA's are all about. And you're concerned with shite posting?

Those pesky facts again from cnbc this am: In April, Treasury yields jumped after U.S. President Donald Trump implemented sweeping “reciprocal tariffs” on international trade partners. The 10-year yield moved above 4.5% and the 30-year rate hit 5%, causing the Trump administration to back off the stiffest tariffs on fears they was causing a financial panic and would raise rates for consumers. But now following the move by Moody’s, the long-term Treasury yields have returned to these levels. Loans for houses, cars and credit cards track these rates. Stock futures were lower as yields surged, with Dow futures down more than 300 points early Monday. Nice try. You can’t absolve trump of the mess he precipitated with his idiotic tariff plan. By your logic, whatever bad happens to the economy is inevitable. BS.