Saturday, March 21, 2009

Prostate Cancer Screening

The New England Journal of Medicine has this study about the effectiveness of prostate cancer screening. Researchers looked at two large groups of men—one group was administered annual prostate cancer screenings, the other group was considered control and was allowed to handle screening however they and their health-care professionals would regardless of the study.

After 7 to 10 years, there was no significant difference between the two groups in terms of deaths from cancer.

I am especially interested in this issue because, back when I worked in bioethics at the University of Washington, prostate cancer screening was one of the primary topics we focused on.

If this issue is new to you, you might wonder why a cancer screening test would need to be studied. Well, it's not entirely clear how effective prostate cancer screening is for several reasons.

To test for prostate cancer, men are screened for a prostate-specific antigen (PSA) in their bloodstream. Sometimes a false positive can be created through the PSA test. Also, prostate cancer can either be fast growing or it can be very slow growing. The fast-growing type obviously needs to be addressed. If a man has the slow-growing type, he may die of something else before the cancer ever becomes an issue for him. In addition, many of the treatments for prostate cancer have major side effects—pain and discomfort but also impotence and incontinence.

Obviously this test can and does save lives. The bottom line is, whether to test for prostate cancer is a complicated decision that should be discussed between patient and doctor. Unfortunately, once a man reaches 50, many doctors just give the PSA test as a regular part of treatment without discussing the pros and cons of it at all.

I hope this study making the news will create more discussion about prostate cancer screening.

1 comment:

Gail Rae said...

I vaguely remember that my maternal grandfather had prostate cancer, apparently the "slow" type, because it was not treated. I remember my mother mentioning it offhand. He died in 1980 in his mid 90's of natural causes, whatever that meant at the time. It seems I remember a relative mentioning that the cause on the death certificate read, "advanced age". I wonder if that "cause" is still officially used.