will already have found some other rationalization of their dependence. Contrary to what Esdaile suggests, the Task Force is not in the business of mounting "campaigns". Its mandate is to determine the strength of the evidence that various preventive measures reduce rates of illness and death and to inform the Conference of Deputy Ministers of Health of this. Richard Goldbloom, MD, FRCPC Chairman Canadian Task Force on the Periodic Health Examination
References 1. Canadian Task Force on the Periodic Health Examination: The periodic health examination: 2. 1985 update. Can Med Assoc J 1986; 134: 724-727 2. Smoking Behavior of Canadians, 1983
(cat H39-66/1985E), Dept of National Health and Welfare, Ottawa, 1985: 21
When your husband turns 50
See your physician for a regular DRE.* If the prostate is other than smooth, firm and round, Then you should have transrectal ultrasound.t Laurence H. Klotz, MD, FRCSC Division of Urology Sunnybrook Health Science Centre Toronto, Ont.
*Digital rectal examination. tAfter urologic resferral.
[The author responds.] I am sorry that Dr. Klotz has chosen to attack my poem by calling it "imaginative and glib". "Imaginative"? - Perhaps true. But "glib"? - No! That won't do! But I'm glad I've inspired Klotz to a ditty That I note is both sharp and quite witty, And his point is quite clearly made too.
From our statistics7 prostate cancer is the second Most common cancer in males, it is reckoned, And, worrisome to relate, From '64 to '88 There was a rising incidence That should cause fears An increase of 144% during those years.
Since there is no known prevention That could possibly deserve our attention, If "health" has a meaning We ought to be screening By TRUS and DRE (or so it appears to me). We ought to get together to work out conditions And conclave to make meaningful decisions
Urologists Radiologists And public health physicians.
The value of ultrasound in impalpable cancers Is clearly referenced. See below for the answers.
Frank I. Jackson, MB, ChB Senior radiologist Cross Cancer Institute
Thus TRUS has this faculty innate To spot lesions that others
Take care of yourself, and when you turn 50
can't palpate,'-4 And by detecting lesions early we may ensure
CAN MED ASSOC J 1990; 143 (12)
As you know, PSAt is definitely not included, As its lack of specificity means it's excluded.6
However, the poem I wrote is in limerick form and is not a sonnet. As for the criticisms:
T n he imaginative and glib sonnet by Dr. Frank I. Jackson (Can Med Assoc J 1990; 143: 177) regarding screening for early prostate cancer by transrectal ultrasonography may be misleading to Canadian physicians. Because screening for prostate cancer is possible does not mean that it will lessen mortality from the disease: the benefits have never been demonstrated in a randomized controlled study. The urologic community continues to regard transrectal ultrasonographic screening as an experimental tool pending the publication of results of well-designed trials. Accordingly, the public health message should read something like the following:
1290
That treatment's more likely to effect a cure.4,5
There has been at least one controlled trial, And I'm happy I've kept its record on file. And they found that TRUS* for their trouble Saw more than DRE, and in fact double. ' If the prostate is "smooth, firm and round" Some will say it's safe and sound. But Lee and colleagues, you see,' Apparently disagree.
Edmonton, Alta.
*Transrectal ultrasonography.
tProstate-specific antigen.
References 1.Lee F, Littrup PJ, Torp-Pedersen ST et al: Prostate cancer: comparison of transrectal US and digital rectal examination for screening. Radiology 1988; 168: 389-394 2. Cooner WH, Mosley BR, Rutherford CL et al: Clinical application of transrectal ultrasonography and prostate specific antigen in the search for prostate cancer. J Urol 1988; 139: 758-761 3. McClellan BL: Transrectal ultrasound of the prostate: Is the technology leading the science? Radiology 1988; 168: 571-575 4. Ajzen SA, Goldenberg SL, Allen GJ et al: Palpable prostatic nodules: comparison of US and digital guidance for fine needle aspiration biopsy. Radiology
References 1. Canadian Task Force on the Periodic Health Examination: The periodic health examination: 2. 1985 update. Can Med Assoc J 1986; 134: 724-727 2. Smoking Behavior of Canadians, 1983
(cat H39-66/1985E), Dept of National Health and Welfare, Ottawa, 1985: 21
When your husband turns 50
See your physician for a regular DRE.* If the prostate is other than smooth, firm and round, Then you should have transrectal ultrasound.t Laurence H. Klotz, MD, FRCSC Division of Urology Sunnybrook Health Science Centre Toronto, Ont.
*Digital rectal examination. tAfter urologic resferral.
[The author responds.] I am sorry that Dr. Klotz has chosen to attack my poem by calling it "imaginative and glib". "Imaginative"? - Perhaps true. But "glib"? - No! That won't do! But I'm glad I've inspired Klotz to a ditty That I note is both sharp and quite witty, And his point is quite clearly made too.
From our statistics7 prostate cancer is the second Most common cancer in males, it is reckoned, And, worrisome to relate, From '64 to '88 There was a rising incidence That should cause fears An increase of 144% during those years.
Since there is no known prevention That could possibly deserve our attention, If "health" has a meaning We ought to be screening By TRUS and DRE (or so it appears to me). We ought to get together to work out conditions And conclave to make meaningful decisions
Urologists Radiologists And public health physicians.
The value of ultrasound in impalpable cancers Is clearly referenced. See below for the answers.
Frank I. Jackson, MB, ChB Senior radiologist Cross Cancer Institute
Thus TRUS has this faculty innate To spot lesions that others
Take care of yourself, and when you turn 50
can't palpate,'-4 And by detecting lesions early we may ensure
CAN MED ASSOC J 1990; 143 (12)
As you know, PSAt is definitely not included, As its lack of specificity means it's excluded.6
However, the poem I wrote is in limerick form and is not a sonnet. As for the criticisms:
T n he imaginative and glib sonnet by Dr. Frank I. Jackson (Can Med Assoc J 1990; 143: 177) regarding screening for early prostate cancer by transrectal ultrasonography may be misleading to Canadian physicians. Because screening for prostate cancer is possible does not mean that it will lessen mortality from the disease: the benefits have never been demonstrated in a randomized controlled study. The urologic community continues to regard transrectal ultrasonographic screening as an experimental tool pending the publication of results of well-designed trials. Accordingly, the public health message should read something like the following:
1290
That treatment's more likely to effect a cure.4,5
There has been at least one controlled trial, And I'm happy I've kept its record on file. And they found that TRUS* for their trouble Saw more than DRE, and in fact double. ' If the prostate is "smooth, firm and round" Some will say it's safe and sound. But Lee and colleagues, you see,' Apparently disagree.
Edmonton, Alta.
*Transrectal ultrasonography.
tProstate-specific antigen.
References 1.Lee F, Littrup PJ, Torp-Pedersen ST et al: Prostate cancer: comparison of transrectal US and digital rectal examination for screening. Radiology 1988; 168: 389-394 2. Cooner WH, Mosley BR, Rutherford CL et al: Clinical application of transrectal ultrasonography and prostate specific antigen in the search for prostate cancer. J Urol 1988; 139: 758-761 3. McClellan BL: Transrectal ultrasound of the prostate: Is the technology leading the science? Radiology 1988; 168: 571-575 4. Ajzen SA, Goldenberg SL, Allen GJ et al: Palpable prostatic nodules: comparison of US and digital guidance for fine needle aspiration biopsy. Radiology
