To test or not to test, this is the question that many men are asking currently. Last Thursday, the U.S. Preventive Services Task Force recommended against the routine screening of prostate cancer screening for healthy men. The panel reviewed many studies and found that the results are failing to show that this type of screening actually saves lives. How you may ask? There are 2 types of prostate cancer, deadly and non-deadly. The screening actually shows both types but doesn’t distinguish between the two, which in fact causes many men to be treated when the disease actually doesn’t pose a threat to them. In doing so, they are faced with consequences from surgery or radiation such as impotence and incontinence.
“The common perception that PSA-based early detection of prostate cancer prolongs lives is not supported by the scientific evidence” task force co-vice chair Michael L. LeFevre, MD, MSPH, professor of family and community medicine at the University of Missouri
Prostate-specific antigen (PSA) is a protein produced by both cancerous (malignant) and noncancerous (benign) prostate tissue which helps to liquefy semen. It is normal for a small amount of PSA to enter the bloodstream but high amounts usually signify the possibility of cancer, since cancer cells usually produce more PSA than benign cells. But PSA levels can also be higher in men that have enlarged or inflamed prostate glands so there is more that needs to be considered than just a PSA score. Other factors to be considered are your age, prostate gland size, changes in PSA levels, and use of medications that may affect PSA such as finasteride (Propecia, Proscar), dutasteride (Avodart) and even some herbal supplements.
So to test or not to test, that is still the question, right? If you are experiencing symptoms such as trouble urinating, decreased force in the stream of urine when urinating, blood in your urine, blood in your semen, swelling in your legs, discomfort in the pelvic area or bone pain you should see your doctor immediately. Also if you are at high risk and have a family history of cancer, or if you discuss the pros and cons with your doctor and want the screening for peace of mind, then go for it.
While this new study from the U.S. Preventive Services Task Force may suggest decreased screening, here is what other groups suggest for PSA screening:
- American Cancer Society suggests men at normal risk should discuss the benefits and risks of testing beginning at age 50, and men in risk groups should begin talking to their doctors at 45.
- American College of Physicians and the American College of Preventive Medicine suggest discussions between men and their doctors starting at 50.
- American Urological Society suggests a baseline screening test at 40, annual screening in all men beginning at 50, and annual screening after 40 for men in known risk groups.
The prostate cancer group ZERO-The Project to End Prostate Cancer had this response to the new report
“Today's decision of no confidence on the PSA test by the U.S. government condemns tens of thousands of men to die this year and every year going forward,” Skip Lockwood, the group’s CEO, said in a statement.
All the confusion and conflicting information leaves one to wonder where do we turn for trusted, reliable information regarding our health? To this question, we don't know.