The Prostate Net^®
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support@prostatenet.org

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The United States Preventive Services Task Force recently published a recommendation that "healthy men" should not use the PSA test to screen for prostate cancer. The Prostate Net vehemently disagrees with this recommendation. While there has been, and continues to be, unnecessary diagnostic tests made and surgery and radiation therapies employed, we must not discard the PSA test as an important tool in the early diagnosis of prostate cancer.

Here are some facts that need to be part of a man's, and his family's, decision making process: here are seven critical facts from American Cancer Society publications to consider.

Every 15 minutes 24/7 an American man dies from prostate cancer.
This year, 5% more men will die from prostate cancer than died last year.
Men have a higher death rate from prostate cancer than women have from breast cancer.
The 5-year survival rate is 100% when prostate cancer is detected in its early stage.
The 5-year survival rate drops to 30% when prostate cancer has spread throughout the body.
African-American and Latino/Hispanic men have lower survival rates than Caucasian men
When prostate cancer is in its early stage and curable, there are no symptoms or self-tests.
When prostate cancer has spread throughout the body, there is no cure; you can only slow its progress.

Some comments from leading physicians in response to the USPTF's recommendation:
"All of us take extraordinary issue with both the methodology and conclusion of that report," said Dr. Deepak Kapoor, chairman and chief executive of Integrated Medical Professionals, a group that includes the nation's largest urology practice. "We will not allow patients to die, which is what will happen if this recommendation is accepted." He and other urologists said that the P.S.A. test is just one part of an overall strategy that, in the hands of well-trained doctors, can help prevent death and other consequences of cancer.

Dr. Derek Raghavan, president of the Levine Cancer Institute in Charlotte, N.C., said that at the very least, men must stop being so anxious about the results of their P.S.A. tests. But even P.S.A. test results that are considered high by many doctors are not dangerous unless the levels are rising rapidly, Dr. Raghavan said. "We need to educate men to slow down," he said.

But Dr. J. Brantley Thrasher, chairman of urology at the University of Kansas Medical Center, said he feared that the task force's recommendation will eventually lead insurers to stop paying for many prostate cancer treatments and lead many men not to get tested. "There is no question that some people are being overtreated in this country," Dr. Thrasher said. "But we can't go back to the day when men waited so long to be treated that all I could do for them was give them narcotics and wait for them to die."

Even the USPTF has included conciliatory wording in the draft of their recommendation:
While the USPSTF discourages the use of screening tests for which the benefits do not outweigh the harms in the target population, it recognizes the common use of PSA screening in practice today and understands that some men will continue to request and some physicians will continue to offer screening. An individual man may choose to be screened because he places a higher value on the possibility of benefit, however small, than the known harms that accompany screening and treatment of screen-detected cancer, particularly the harms of overdiagnosis and overtreatment. This decision should be an informed decision, preferably made in consultation with a regular care provider. No man should be screened without his understanding and consent; community-based and employer-based screening that does not allow an informed choice should be discontinued.

We agree with this position and encourage men over the age of 40 to get a PSA test, just as they would a blood pressure test, blood glucose level, or cardio-vascular evaluation as part of determining their overall health. To help you understand the controversy about the PSA test, and to help you make YOUR informed decision, we have produced an educational manual that summarizes all of the current points of view on the subject. Send an email requesting a copy to: support@prostatenet.org.

A Joint Statement from America's Prostate Cancer Advocacy, Education, and Support Organizations on the PLCO study reported in the New England Journal of Medicine on the efficacy of PSA screening - Click Here!!

Info on the PSA test and the USPTF recommendation - Click here.

News Sources

The Doctors Channel - Site listing short information videos on many subjects relating to prostate disease management

News - Medical Net - a source for daily news releases of information important to patients and professionals.
Medscape - an on-line resource for patients and professionals; for a specific recap of major clinical literature check this link.

MedLine Plus - searchable database of the most important consumer and professional publications on the disease provided by the National Institutes of Health.

CURE - magazine and site geared to provide the latest developments in cancer research.

Cancer News on the Net - an Internet publication written for all cancer patients and their families.