WWYDD-What Would Your Doctor Do….Regarding His PSA?

I’m sure you have all heard about the current controversy around prostate cancer screening using the PSA (prostate specific antigen) test.  A recent panel, U.S. Preventive Services Task Force, consisting of physicians, including a pediatrician who certainly does not diagnose or treat men with prostate cancer just came out against screening for prostate cancer.  The American Urological Association, which I am a member, is outraged at the task force’s recommendation. 

What are the facts?

Prostate cancer is the second most common cause of cancer death in men following lung cancer.   There are 32,000 men who die each year from prostate cancer.  If many of these men were screened with a PSA test and a digital rectal exam, they would likely have had their cancer detected at an early stage, i.e., localized to the prostate gland and, therefore, curable.  Failure to screen means that men will likely present with prostate cancer that has moved outside of the prostate gland and spread to bones and other tissues and organs.  Disease that has spread to bones can be very painful and lead to a very slow and agonizing demise.

So what did your doctor do?

I get a PSA every year and recommend it to all of my patients who are over the age of 50.  I recommend that younger men who are at a higher risk for prostate cancer such as African American men and men who have a close relative such as father, brother or uncle, start testing in their 40s.  I stop testing men over age 75 as prostate cancer in this age group is less to cause death and the older man is likely to die of some other cause such as heart disease.

Bottom Line:  I recommend you speak to your doctor and discuss the pros and cons of screening and then make the decision whether screening is right for you. It may also be of interest to ask your physician if they obtain a PSA or if their significant other does. 

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