Statistically it’s much better when it’s exactly the same

It’s very easy to get confused over prostate cancer screening – doctors do it all the time! Currently in Australia there are SEVEN distinct “official” recommendations regarding who should be screened for prostate cancer and how often.  It’s no wonder nobody actually knows what to do.

The big debate of course, is whether prostate cancer screening should be done at all.  Both sides of the debate present statistics, and they can be twisted to defend any position at all.

Here is a great example we came across.

FACT – Survival rates for prostate cancer in America are about 80%.   In England 43%.

FACT – the chance of dying of prostate cancer in America is virtually identical to the chance in England.

OK….how do we reconcile those two completely true, but apparently contradictory, facts?

Here’s how.

Americans love screening and they test lots of people for prostate cancer very often.

And they love treating prostate cancer, no matter how early they find it.

So in America – 136 out of 100,000 men are found each year to have prostate cancer. You can bet nearly all get some sort of treatment.

In England, where many fewer men are screened, only 49 out of 100,000 men are diagnosed.

Now, if all prostate cancers mattered, you would think that the diagnosis in lots of men in England is being missed, that their treatment is being delayed and that they will die as a result.
But the rate of death from prostate cancer in England is 28 per 100,000 men per year.  In America, its trivially better at 26 per 100,000.

In other words, your chance of being TOLD you have prostate cancer in America is more than double in England (136 vs 49).  But your chance of DYING of prostate cancer is basically the same (26 vs 28).

Since more men are diagnosed and treated in America, it looks like regular screening, early diagnosis and aggressive treament is more effective, even when the end-results are the same.

The conclusion?  Research statistics are very dangerous creatures and need to be handled with care.  Talk to your GP about YOUR personal risk.

 

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Along with this blog, we’ve also launched a Twitter feed. You can now get a health message update from the practice most days by following us on Twitter. Our name is @wellonwell

Most of our tweets (and blog entries) will be about health issues in the news.  Occasionally we will let you know about coming, goings and gossip at the practice…..like this one. We are delighted to announce that Dr Tim Tai, our very popular registrar from 2011, will be returning to the practice as a GP from February 12th.   Appointments can be made by calling the surgery on 9780 8900.

 

 

It’s gotta be done

A new study – done in Victoria, so the findings are really relevant to our patients – shows one-third of patients who are first-degree relatives of someone with bowel cancer have never had a colonoscopy.

Now having a colonoscopy may not be the most fun reason to take a day off work, but finding bowel cancer early – and having a parent or sibling with the disease puts you at significantly increased risk – is genuinely life saving.  The new edition of the practice newsletter (about to go to the printer, but will soon be available at the surgery or at wellonwell.com.au) talks about why Faecal Occult Blood Testing (pooh test) is worthwhile for all adults over fifty. But with a family-history of bowel cancer – colonoscopy is the only way to go.

Flu shots in pregnancy

A huge Norwegian study (published in the prestigious New England Journal of Medicine) has shown that flu vaccine is not only safe during pregnancy but helps protect the mother and possibly the baby from nasty complications.

See

Nearly 120,000 women were studied, and the researchers showed:
– contracting flu during pregnancy almost doubles the risk of the fetus dying
– vaccination cuts the risk of getting flu by 70%
– pregnant women who were vaccinated had less risk of complications of flu (including less death)
– the babies of vaccinated women did not suffer any more complications. In fact there was a suggestion (but not proof) that they were born healthy more often.

Flu vaccines can be given at any time during pregnancy – even in the first trimester.

We’ll let you know when the flu vaccine is available at the surgery.

Who should shoot?

There is a bit debate going on in the medical press at present over moves by pharmacists to adminster vaccines and immunisations. The AMA has released a position paper saying they think pharmacists should be trained before giving vaccines – but even if trained, they don’t support it! The Pharmaceutical Society of Australia have drawn up their own guidelines and standards which they think will adequately protect patients.

Our view is that it is in patients’ interests to be immunised by a doctor. Here is why:

1 – If we don’t do the shot, we don’t record the shot. And 3 years later you don’t remember exactly which injection was given or when a booster is due. If a batch is later declared suspect – we record the batch number and can contact our patients list….but only if we have the information.

2 – Most pharmacies have inadequate privacy for administering injections.

3 – And if they do have a screened area or a private room, where does the patient (our term) or customer (their term) sit under observation for the next ten minutes.

4 – Most pharmacies do not have adequate resucitation equipment or training. Whilst serious reactions to vaccinations are rare, they certainly occur. We believe every immuniser needs access to a bed to lie on, oxygen, adrenaline, IV fluids and cannulas. We are not aware of any pharmacy that can offer those safety features.

We hope this doesn’t sound like an attack on chemists. Pharmacies provide great service to patients and we have an excellent relationship with all the chemists in our area. But our belief is that when things go wrong, a vaccination should be done in a medical clinic – and you don’t know that things will go wrong till they have.

Welcome to Wellness on Wellington

Welcome to the Wellness on Wellington Blog.

We have two aims for this blog.

First – we want to keep you updated with happenings in the practice. New staff, change in availability, arrival of flu vaccines and so on.

Second – we know that the popular press is full of stories on health and medical issues. But often those stories are misinformed, lack perspective or only apply in certain cases. We hope to use this blog as a way of quickly letting our patients know what we think, to help you make informed choices. 

We’d love your feedback on how we are doing.