Prostate screening common in elderly men, poll shows
Forty percent of doctors responding to an online poll said that until now, they have routinely screened elderly men for prostate cancer, a practice a government agency now says tips the risk-benefit balance the wrong way.
Last week the US Preventive Services Task Force concluded that testing men over 75 for the slow-growing cancer, even men at high risk, carries too much potential for harm compared to possible benefits. Treatments can cause troubling side effects, including incontinence and impotence, and the benefits are uncertain in older men who may die of another cause first, the recommendation says. For men under 75, the evidence is not as clear on whether the benefit outweighs the risk.
Physician’s First Watch, an e-mailed newsletter from the publishers of The New England Journal of Medicine, asked its readers about ordering prostate-specific antigen, or PSA, tests for their patients. Black men and men with a family history of prostate cancer are considered more likely to develop the disease.
Today's results show that of the 494 responses, 40 percent screened all older men, 29 percent screened only high-risk patients, 15 percent never screened men over 75, and 16 percent said prostate cancer screening was not part of their practice.
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5 years ago, when I turned 50, I had my PSA checked for the first time. When the results came back, it was 400% higher than it was supposed to be. No typo there - four hundred percent.....I was presented with all the treatment options and elected surgery. Today I am alive and cancer free because of the skillful work of a great guy and even greater surgeon, while a close friend with the same diagnosis and the same treatment (different medical team) passed away last year. There was no history of any cancer of any kind in my family at the time. The only reason this was caught was my personal physician and his insistence that I get the PSA test. No symptoms no nothing, just a wicked case of prostate cancer.
Mike, I am glad you are doing well, but your comment and experiences of you and your friend show why the PSA is not a good test (I am going to take a lot of license and make a lot of assumptions about you and your friends cancer and care).
Perhaps it was not the different medical teams that led to different outcomes between you and your friend, but just different types of prostate cancer. You may have had a relatively benign form of prostate cancer that happened to release lots of PSA and your prostate cancer may never have caused you any problems. Your friend may have had a very aggressive prostate cancer that released relatively little PSA. In fact, having your PSAs checked may not have affected your outcomes at all.
I know my assumptions will make a lot of men -- men who have had their prostates removed and may be impotent, incontinent or both -- mad, but PSA screening has never been shown to reduce mens' chance of dying from prostate cancer. PSA screening has been shown to increase your chance of being diagnosed with prostate cancer.
Here's hoping we come up with a better test.
This subject is about early detection so important to survival. No one questions that a better testing method than the current PSA system would be highly desirable . But it is still the best currently available so why not deploy it in as sensible a manner as possible.? It should never be used as the initial step in any treatment procedure but instead to justify biopsies that really tell whether or not you have cancer . Secondly, a single PSA, standing alone, has very little significance because of other sources of PSA. But a string of them, accurately plotted on semi-log graph paper can be a valuable tool in making sound treatment decisions I leaned this from a great urologist I consulted with who said " You know ,prostate cancer cell growth is logarithmic in nature?"
This blogger might want to review your comment before posting it.
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