title: Prostate cancer screening and disease management: how screening may have an unintended effect on survival and mortality-the camel's nose effect.
abstract: OBJECTIVE
  Evidence suggests that men diagnosed with prostate cancer live as long as or longer than those without a diagnosis. We postulate that a reason for this paradox is increased preventive and therapeutic health care interventions following a prostate cancer diagnosis. We explored this phenomenon in patients surgically treated for prostate cancer.
  
  
  METHODS
  We examined the records of patients who underwent radical prostatectomy at Audie L. Murphy Veterans Hospital between 2001 and 2004, focusing on cancer related and comorbidity data including new diagnoses, interventions and medications.
  
  
  RESULTS
  A total of 174 subjects had complete data for review. Of these men 72% had a change in medical regimen after diagnosis, 61% had a change in medication and 29% received a new medical diagnosis. Three men underwent cardiac catheterization and 1 had coronary bypass surgery.
  
  
  CONCLUSIONS
  These data highlight the extent of evaluation and subsequent changes in medical treatment regimens that occur after a diagnosis of prostate cancer. Such interventions would be expected to affect survival outcomes of men recently diagnosed with prostate cancer.
authors: Department of Urology, The University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229, USA. walshr@uthscsa.edu
authors: Rhonda M
authors: RM
authors: Walsh
authors: Ian M
authors: IM
authors: Thompson
mesh_terms: D006801:Humans; D008297:Male; D008403:Mass Screening; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy*; D015996:Survival Rate