Prostate cancer screening with a PSA test may not save lives. The prostate specific antigen or PSA test has been controversial for years. Many doctors have relied on the PSA test to help identify men who may have prostate cancer that requires treatment. Recently, though, experts have been debating the value of this screening test. The Preventive Services Task Force recommended that healthy men forego routine PSA screening because it doesn’t save lives and may lead to unnecessary interventions. Now a study from Europe shows that the test can help with prostate cancer detection and reduce deaths from the cancer. But the overall mortality rate was the same for men who were screened and those who were not.
The researchers followed over 180,000 men for more than a decade. The investigators concluded that 1055 men would need screening to prevent one prostate cancer death. They also found that approximately half of the cancers found through screening should be considered overdiagnosed. They were cancers that would not have caused the men difficulty. An accompanying editorial in the New England Journal of Medicine suggests that this study supports the recommendations of the U.S. Preventive Services Task Force that the PSA test not be used for routine screening.
[New England Journal of Medicine, March 15, 2012]

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  1. Lee
    Reply

    I went for a visit to the doctor and when he found my blood pressure was high he had blood tests done. After finding a high PSA reading they did a biopsy and all twelve samples had cancer cells. They followed that with a CT scan to see if the cancer had spread to other parts of my sexual organs and discovered a malignant tumor on my kidney. Maybe 1054 screenings might not have been useful, but the 1055th (mine) was life saving.

  2. Miffa
    Reply

    As a prostate cancer survivor, I think this is nonsense — akin to sticking your head in the sand. Granted, the traditional PSA test isn’t perfect, but it’s the best we’ve got, and getting better as more sophisticated analyses are developed. If used properly, with good history and attention to things like PSA velocity, it’s a pretty good indicator of when you should consider further action. I had monitored my PSA for over 15 years, and a sudden rise was the red flag that triggered a biopsy and subsequent successful treatment.
    The biopsy itself is nothing to brag about either. While not painful, it’s moderately invasive, and only a statistical sampling that invites both false negatives and positives — but again, used properly, it’s a pretty good predictor of when you should consider therapy.
    The common alternatives to regular PSA testing, either the DRE or symptoms, can be poor indicators as well and carry risk of delaying detection until well after effective therapy with little or no negative side effects is an option.
    The final leg on the stool is the therapy itself. If you choose a therapy with poor outcomes and/or ugly side effects, early detection may not make all that much difference, and the study shows that. If you do your research, as I did, you might be lucky enough to undergo proton beam radiation therapy — and actually enjoy your treatment regimen and lead a healthy, active life both during and after completion of your treatment.

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