Effectiveness of Prostate Test Questioned in Helping Cancer Patients

This week, two very important studies regarding prostate cancer screening were published in the New England Journal of Medicine. The studies concluded, essentially, that screening and early detection of prostate cancer with the PSA test does not reduce morbidity or mortality in men.

The studies are an unusual contrast to the notion that early detection and treatment benefit one’s health. Ordinarily, a delay in cancer diagnosis has a serious impact, and can result in claims for medical malpractice, personal injury, and wrongful death. This may not always be the case with current prostate cancer screening tests.

There is no doubt that in some cases, the PSA test detects aggressive forms of cancer at an early stage, allowing men to undergo timely and lifesaving treatments. However, the majority of prostate cancers are slow growing and do not adversely affect a man’s health or lifestyle, particularly in elderly men.

Unfortunately, treatment for prostate cancer is invasive and includes biopsies, surgeries, and other treatments, which may result in urinary incontinence and/or erectile dysfunction. Radiation treatments can cause additional complications. The question then, based on the results of the recent studies, is whether the benefit treating a prostate cancer (removing a potentially harmless cancer) outweighs the risk of the treatment itself (incontinence, erectile dysfunction). The treatment may actually be unneeded, and a cause of unnecessary injury.

The studies published in the New England Journal of Medicine seem to indicate that for most men, there is no proof that biopsies, surgeries, and other treatments actually extend the man’s life. In fact, the evidence proving that the benefits of prostate cancer screening outweigh the risks is lacking.

It is currently recommended that men between the ages of 40 and 75 undergo PSA testing. However, the results of these studies call into question the usefulness of the screening. Many urologists are now recommending the decision to undergo PSA testing and/or prostate cancer treatment be made on an individual basis until more is know regarding the risks and benefits of PSA screening.

For More Information:

Perspective Roundtable: Screening for Prostate Cancer, video discussoin, March 19, 2009

Perspective Roundable: Screening for Prostate Cancer, New England Journal of Medicine, March 19, 2009 (transcript)


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