Doctors Differ On Prostate Screening
Some doctors and analysts believe screening for PSA, which stands for prostate-specific antigen, leads to unnecessary, costly, and even harmful surgical procedure because so many early diagnoses are slow-growing malignancies that don’t require immediate treatment. But men typically demand care once they listen to the “C” word. Those on the other side say PSA screening process remains a valuable tool for detecting a tumor early and conserving lives.
Last month, The American Urological Association reversed course and no recommends program verification for men 40 to 54 years of age longer, who face an average risk of getting prostate cancers. It said testing should be considered for those 55 to 69 primarily. Even then, a PSA test shouldn’t be automatic. Men should talk to their doctors about the benefits and dangers and “proceed based on their personal values and preferences,” the association recommended. A nagging problem with screening is that PSA levels can be high, indicating cancer, even though a man doesn’t have it.
Another concern is that if a biopsy detects cancer, it is very slow-growing and, as cancers go, relatively benign. In other words, a PSA test was taking healthy men and turning them into cancer patients who underwent radiation therapy, surgery, and other invasive techniques for something that would cause death or even lead to any observable symptoms never. But even seemingly benign cancer can turn serious. And some men want to turn back any risk of cancer immediately.
Four years back, Michael LeBlanc, 62, didn’t even think about waiting around to treat cancer detected in his prostate. If the cancer was slow-growing or more intense was a moot point, he said. Dr. Otis Brawley, main medical officer for The American Cancer Society, has needed more extreme caution with prostate tumor testing long, speaking against mass screenings like the ones offered by health companies at stores. Many patients, he said, don’t fully realize the problems associated with PSA screening. That decision, he said, should be predicated on weighing the huge benefits versus potential harm of screening.
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Research of men 55 to 69 suggests PSA screening process may prevent one loss of life from prostate cancer for every 1, year intervals over a 10-year-period 000 men screened at two-to-four, based on the American Urological Association. At the same time, a lot of men who get the testing will be harmed because of treatments that can lead to health complications.
Even a biopsy poses a risk of illness, for example. Doctors may recommend “active surveillance” for men with low-risk prostate cancers tumors, in which the tumor is monitored rather than treated. But getting patients to watch and wait is a hard. Dr. Martin Sanda, chairman of the Department of Urology at Emory University School of Medicine and director of the Prostate Cancer Center in Emory’s Winship Cancer Institute. More than a 5-to-10-year period, about a third of men whose cancers are believed low risk switch worse and require treatment, relating to Sanda. Sanda said a patient’s decision about whether to monitor the low-risk cancer or go through treatment often depends on how the information is shown.
The key, he said, is detailing that the biopsies not only detect aggressive cancers that require immediate treatment but also pick up cancers that are “quasi cancer tumor” and safe to view rather than treat immediately. But not all doctors are comfortable with the concept of simply waiting and watching entirely. Dr. Marc Harrigan, a primary-care doctor at Piedmont Hospital. Harrigan said his patients are mainly African-Americans who face a higher risk for prostate malignancy. They have a tendency to opt for screening before 50. But Harrigan reviews the pros and downsides of screening for just about any patients 40 and up. And he lets the individual to decide whether or not to get the PSA test.