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unicorn

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  1. Penile cancer is quite rare in the developed world, hence the lack of response from the group (unlike prostate cancer, which is extremely common). As with most cancers, staging and classification have a huge impact on prognosis, so your urologist will be in the best position to prepare you for what to expect. It's extremely different from other cancers such as prostate or bladder, so I would definitely not generalize from the experience of someone who had a different type of cancer. Penile cancer is essentially unheard-of in men who were circumcised prior to puberty. You didn't mention where you're located, but, unless it was caught at a very early stage, it would probably be wise to at least get a consultation at a university-based specialized cancer center, since this cancer is quite rare, and even most urologists and oncologists have little experience with it. If it were me (I'm in the US), I'd want to get a consultation from UCLA, MD Anderson, Mayo Clinic, Harvard, Johns Hopkins, or some similar specialized place.
  2. Given the unpopularity of Biden, whom many Americans blame for inflation, although most of that is clearly due to (1) supply-chain problems from first COVID, then from China's "Zero-Covid" policy, (2) the war in Ukraine, with loss of food exports, and (3) OPEC throttling back production in an attempt to hurt Democrats, the failure of Republicans to do better should be a clear wake-up call for them. Elections are decided by independents, not Democrats or Republicans. And my feeling is that most independents are just as horrified by the antics of Trump and the GOP as most Democrats are. Independents may not like Biden much, but the alternatives seem to be worse.
  3. Live together in a loving relationship and support each other, but not married.
  4. I'm 60 and my domestic partner is 29. We introduce each other as domestic partners. I'm not sure it's wise to visit Russia these days, but if you were to do so, I'd be more careful and say he's your nephew.
  5. Yes, that's correct. If it's been a week since you tested positive, you're no longer contagious (in fact, you're no longer in danger of becoming contagious, so in an extra-safe group).
  6. I got it.... I clicked on my Avatar, then saw the symbol in the upper left. Thanks!
  7. Well, when I try to click on profile, there doesn't seem to be anything clickable. It just says that my profile is 100% complete....
  8. I've looked at my profile for a way to change my avatar, but haven't been able to figure it out. How does one change one's avatar here?
  9. The crazy Chinese policy has caused havoc not only for China's economy, but for most of the planet. Supply chain problems have lowered supply, thereby increasing prices in most countries, leading to inflation.
  10. I would strongly caution you, for your own sake, to be wary of any seminar or "check-up" offered by someone with a financial incentive to find trouble. Of the tests you mentioned, none is generally recommended by unbiased professional recommendation groups, especially the USPSTF, other than that there's a "C" recommendation for PSA screening in men from 55 to 69 ONLY. The "C" recommendation means there's little evidence for benefit, or benefits and risks are pretty balanced, but might be reasonable per patient preference after a thorough discussion of risks and benefits. Although it seems counter-intuitive that more information can lead to worse outcomes, this fact often appears to be the case in medicine.
  11. Yikes! You should strongly consider getting a new GP. First of all, there's NO evidence gay men have higher PSA levels, whether they bottom or not. In fact, studies have shown that ejaculating more frequently seems to LOWER the risk of developing prostate cancer (which makes sense, intuitively, because you're clearing out your prostate more frequently): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5040619/ "...These findings provide additional evidence of a beneficial role of more frequent ejaculation throughout adult life in the etiology of PCa...". Also, if a person, knowing the risks and modest benefits of prostate cancer screening, still wishes to undergo this screening, a blood PSA level is the only way to do it. This screening cannot be done with any urine test.
  12. I can tell you 100%, that the strong implication of the article (which, again, has no scientific references) that active surveillance is almost never a good idea is absolute NOT what I got out of it, but that's because I have more information. However, any lay person reading that article would probably conclude (incorrectly) that active surveillance is usually a lousy alternative. For example, it states "If you have other health problems that limit your life expectancy, active surveillance for prostate cancer may also be a reasonable approach....". Well, any national guideline will tell you that if a man has health problems that limit his life expectancy, PSA screening is entirely inappropriate in the first place. The USPSTF gives it a "D" recommendation which means "Don't do it because there is strong evidence that it's harmful." Another obvious way that article is misleading (very obvious, in fact) is that it list "Risks" of active surveillance, but not the "Benefits"! Any competent physician should be able to explain the risks and benefits of alternative treatment options, and not just sway the patient with one-sided information. In fact, it's the law (at least in the US)--that's why it's called INFORMED consent, not just "consent." Mind-blowing to me, it actually lists as one of the "risks" of active surveillance as "Frequent medical appointments. If you choose active surveillance, you must be willing to meet with your health care provider every few months." As if other treatment options don't involve lots of other medical appointments?? WTF?? Warning patients about having to meet with his health care provider 3 times a year (and get a blood draw), but not mention the many risks of surgery or radiation? Yes, obviously these decisions are personal. However, decisions with such major potential consequences should be made with all of the facts well laid-out, in a manner most patients can understand. In making such important decisions, patients deserve information given in a factual and unbiased manner, not in a clearly one-sided and leading article. The fact that the Mayo clinic is well-rated doesn't mean they can't put out articles which fail to accurately describe risks and benefits (clearly the case for this article). These articles don't factor into the ratings of hospitals/medical centers.
  13. It's interesting to read that article (which doesn't have references). Although it's not apparent to those who are unsophisticated in these matters, it quietly discourages active surveillance. For example, it states "Active surveillance may be best suited if you have a low Gleason score (usually 6 or lower), which indicates a less aggressive, slower growing form of cancer." That statement implies that a Gleason score of under 6 is possible, which it is not. Urologists may dishonestly imply that the Gleason score is a range of 1 to 10. However, the lowest possible score is, in fact, 6, and a score of 7 is actually fairly favorable: https://www.pcf.org/about-prostate-cancer/diagnosis-staging-prostate-cancer/gleason-score-isup-grade/ "...Theoretically, Gleason scores range from 2-10. However, since Dr. Gleason’s original classification, pathologists almost never assign scores 2-5, and Gleason scores assigned will range from 6 to 10, with 6 being the lowest grade cancer...". While it is true that a score of 6 means the cancer is highly unlikely to metastasize, the Mayo Clinic article implies that a score of 7 is dangerous and not suitable for active surveillance. That's simply not true.
  14. Just to bring in some science into the discussion, most of the prostate cancers detected by screening (as opposed to those which appear due to symptoms) will never affect the life of the person who has that cancer. Screening asymptomatic men for prostate cancer has NO effect on overall mortality. There is a minimal improvement in prostate cancer mortality, but this is balanced by increased deaths caused by unnecessary treatment. This is probably true because once diagnosed, few men choose the wisest course, which, in many cases, is watchful waiting. The immediate response usually comes as "Aaack! Get it out!", often spurned by financial interests of the urologist or radiation oncologist. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/prostate-cancer-screening#bootstrap-panel--5 "Adequate evidence from randomized clinical trials (RCTs) shows that PSA-based screening programs in men aged 55 to 69 years may prevent approximately 1.3 deaths from prostate cancer over approximately 13 years per 1000 men screened.3, 4 Screening programs may also prevent approximately 3 cases of metastatic prostate cancer per 1000 men screened.3 Current results from screening trials show no reductions in all-cause mortality from screening. There is inadequate evidence to assess whether the benefits for African American men and men with a family history of prostate cancer aged 55 to 69 years are different than the benefits for the average-risk population."
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