Have You Had a Screening for Prostate Cancer?

I have written a couple of articles about prostate issues. This summer my husband had surgery called a TURP to make his enlarged prostate smaller. True he was symptomatic but the PSA tests (which measures a protein released by prostate cells) he's had over the years have made us both crazy. One time it was 18 and we were sure he had cancer. We then found out he had an infection. Still when we were talking about the latest research this morning which found that this test does not save a whole lot of lives and could lead to risky and unnecessary treatments we were both not surprised by yet unnerved by the findings. .

The findings which are the first that have been based on rigorous, randomized studies, confirm concerns about how wise it is to do prostate cancer screening. Although the studies are continuing, results so far are considered significant and the most definitive to date.

The PSA test, does what it is supposed to do and that is to show that cancer might be in your prostate which then leads to biopsies to determine if there is a tumor. I cannot even count how many biopsies my husband has had. The problem is that it has been difficult to know whether finding prostate cancer early saves lives. Most of the cancers tend to grow very slowly and are never a threat and, with the faster-growing ones, even early diagnosis might be too late. Some of us say that most men die with prostate cancer rather than from it.

One study was done in Europe and the other here in the United States. The chief medical officer of the American Cancer Society thinks that the studies are super important to the health of men.

Dr. Peter B. Bach, a physician and epidemiologist at Memorial Sloan Kettering Cancer Center in New York, says "one way to think of the data is to suppose he has a PSA test today. It leads to a biopsy that reveals he has prostate cancer, and he is treated for it. There is a one in 50 chance that, in 2019 or later, he will be spared death from a cancer that would otherwise have killed him. And there is a 49 in 50 chance that he will have been treated unnecessarily for a cancer that was never a threat to his life."New York Times

Personally I am more aggressive in some ways and would want my husband to go ahead and get tested though whether there is treatment is another story. I have abnormal ductal hyperplasia (I'll do an article on it) and it was suggested I go on Tamoxifin. I chose not to. Still I'm glad that I had the choice and knew what the pros and cons were.

Prostate cancer treatment (and even my husband's surgery for non-cancer treatment) could have resulted in impotence and incontinence.

Both reports were published online Wednesday by The New England Journal of Medicine. One involved over 180,000 men in seven countries in Europe. The other by the National Cancer Institute involved 10 medical centers in the United States and over 70,000 men. In both, participants were randomly assigned to be screened - or not - with the PSA test, In each study, the two groups were followed for more than a decade while researchers counted deaths from prostate cancer, asking whether screening made a difference.

The two studies looked at togther found that screening was associated with a 20 percent relative reduction in the prostate cancer death rate. But the number of lives saved was small - seven fewer prostate cancer deaths for every 10,000 men screened and followed for nine years.

Sources

New York Times
CNN