From: "Kristian Dahl-Madsen"
Date: Thu Nov 3, 2005
Subject: * * * About the A.M.A.S. blood test
Kristian Dahl-Madsen wrote:
I want to add the following to the discussion about the AMAS cancer
test:
One random prostate biopsy has certainly LESS THAN 50% PROBABILITY
of finding a small cancer.
Nine random biopsis will increase this probability to less than 87%.
This means that there is still more than 13% chance that you will
miss an early cancer detection just at the stage when the chance of
sucsesful treatment is best !!!
It has been found that the AMAS test is 99% accurate if you take two
tests within a few days and both are either positive or negative.
My position is that when a moderatedly elevated PSA is found then
the best choise is to take the AMAS test. In case this shows cancer,
then take a whole body PET scan to see where the cancer is placed
(or spread).
Then it may be appropriate to take biopsies to find the
agressivenes of the cancer.
Ellis: I am against taking biopsies except if they are done on the
prostate after it is removed... because I am afraid it might
allow cancerous cells to spread outside of the prostate. In any case,
knowledge of how aggressive is the cancer can be seen through the
PSA doubling rate, comparative ultrasounds, etc...
There is no special benefit gained in taking a Gleason except to
satisfy your curiousity, and it is better to remain alive than to
satisfy your curiousity. And I think there is a real risk which
can be a matter of life and death.
So, to me, it is not worth taking a biopsy.
The AMAS test is probably the best choice in all respects.
Ellis: THIS SETTLES THE ARGUMENT between Dr. Strum's position insisting on biopsies to determine if there is a cancerous tumor, and MY argument that all biopsies are dangerous and should be avoided because
the test itself might cause the cancerous cells to spread outside of the prostate.
I paste the relevant part of recent post 9191 in the box, below, with "WE STILL DON'T KNOW" capitalized by me...
Read the entire post, to which I also gave three stars, which means
"this is an exceptionally good post"... :
Post 9192
================================
Dr. Strum: Dr. Avrum Bluming, another medical oncologist in
Southern California, has done AMAS tests in over 60 patients in his
practice. His data indicated a false positive rate of <5% and a false
negative rate of approximately 7% for AMAS.
Clearly, the AMAS test has demonstrated clinical usefulness for the
diagnosis of cancer.
Therefore, we ask how does AMAS improve upon or add to diagnostic or
prognostic information for prostate cancer patients that can already
be obtained by physicians using PSA and other diagnostic tools?
For the moment, the answer is "WE STILL DON'T KNOW." However, we are
currently working closely with Dr. Bogoch to answer these questions.
Ellis: [I can answer that question without hesitation, for me. If the PSA is high so that the doctor and I suspect cancer, I would take the AMAS to let
me know if it is cancerous, or not yet cancerous. I would not allow
a biopsy. Dr. Strum says "we still don't know," because he would ask for a biopsy, which he thinks is the ultimate test to determine if a prostate tumor
is cancerous. - Ellis]
Dr. Strum: To definitively diagnose prostate cancer, PSA and certain
other tumor markers should always be used in conjunction with a DRE
(digital rectal examination) and TRUSP (trans-rectal ultrasound of
the prostate) with needle biopsies. A single blood test result (PSA,
AMAS or any other) should never be used alone to establish or refute
the possible diagnosis of cancer.
============================================
Ellis: Whether I am RIGHT or I AM WRONG to fear that biopsies are DANGEROUS
is now besides the point. The AMAS test is 95% accurate, and NINE
BIOPSIES are 87% accurate... so the AMAS test IS 8% MORE ACCURATE than NINE biopsies, each of which is DANGEROUS "according to Ellis."
I accept a digital rectal examination, and I accept a trans-rectal
ultrasound of the prostate, but I DO NOT agree with Dr. Strum that
needle biopsies of the prostate should be performed, because I
would fear they could cause cancerous cells to be released outside
of the prostate, with very bad prognosis.
There is no reason to argue anymore to see whether I am right or mistaken
to fear biopsies... the only question now is: which test is more accurate?
The A.M.A.S. is a BETTER test because it is MORE ACCURATE than 9 biopsies...
better, as you said, in all respects.
Kristian: I am very grateful to you for the information receive via
Rejuvenation. It has helped me a lot.
Kristian Dahl-Madsen
And I am very grateful to you and to all the doctors and all the
patients on Rejuvenation who have also helped me a lot too with
their feedback, questions, and comments. I learned very much from
your feedback today, too. THANKS FOR SENDING ME THIS, about
A.M.A.S... You see how I LEARN from answering the posts?
I think I will have to send this one to Dr. Strum... perhaps he
will find the answer to his question also.
By the way... I HIGHLY RECOMMEND you should read WITHOUT FAIL:
"Primer on Prostate Cancer: The Empowered Patient's Guide"
by Dr. Stephen B. Strum and Donna L. Pogliano. If you don't have it,
let me know and I'll send it to you.
- Ellis]
