Does Prostate Cancer Screening Cause More Harm Than Good?
Recent Blog Entries From Dr. Dave Hnida
This recommendation is new; the task force is not. It’s best known for its well-publicized recommendation against routine mammograms for women — made a few years ago — a recommendation that raised howls across the globe.
This recommendation is slated to say that routine blood testing via PSA is, for most men, a waste of time. In fact, they say the screening may be more harmful than helpful. That’s because some men may learn they have an elevated level of PSA in the blood, then undergo aggressive biopsies and other testing that shows no problem.
Other men who do, in fact, learn they have cancer after a biopsy, opt to undergo aggressive treatment for that cancer even though the cancer is slow-growing and will never cause a problem (yet the treatments can — causing, in some cases, things such as impotence or loss of bladder control).
So what’s a man to do? Even though the report hasn’t been officially released, it’s already raised a lot of hackles in the medical world. Meaning, a lot of doctors are saying the report is wrong, and men should continue to be screened.
It’s a tough call, because right now there isn’t a way to tell whether a cancer is slow-growing, or one that’s fast growing and deadly. And that’s the rub.
My advice to patients will be made on an individual basis: I still think the test is most useful in younger men (under 65), and those who have a family history of cancer. But I may yet advise a healthy 70 year old to get a rectal exam and a PSA — you see, one size of advice doesn’t fit all.
It’s after the diagnosis of cancer where the advice really needs to be given. I think many doctors agree aggressive surgery and other treatment isn’t always a good idea. Instead, there should be more watchful waiting — see what the cancer does. Tough advice, since once a man learns he has cancer, he often wants it out ASAP.
BTW, the current recommendation for PSA screening is every year beginning at age 50, younger (40) in men with a family history or those in a high risk group, such as African-American men.