Controversial advice coming from the U.S. government is challenging the traditional belief that PSA screening for prostate cancer is a necessary practice.
The U.S. Preventive Services Task Force says a PSA blood test should not be part of regular screening for healthy men.
The report, which has not yet been made final, states that the routine PSA screening did not reduce the number of deaths and often led to serious side effects from treatments that were unnecessary.
It’s a hard pill to swallow, when men have been told for years that early detection of prostate cancer is key.
“There’s this dogma … that early detection saves lives. It’s not necessarily true for all cancers,” says Dr. Yul Ejnes, a Cranston, R.I., internal medicine specialist.
The recommendation has already raised the ire of doctors in the U.S. with many rejecting it from the outset.
PSA screening
Too much PSA, or prostate-specific antigen, in the blood only sometimes signals prostate cancer is brewing. It also can mean a benign enlarged prostate or an infection. In fact, most men who undergo a biopsy for an abnormal PSA test don’t turn out to have prostate cancer.
Screening often detects small tumours that will prove to be deadly – by one estimate, in two of every five men whose cancer is caught through a PSA test. But there’s no way to tell in advance who needs treatment.
Prostast cancer treatment side effects
– Up to five in every 1,000 men die within a month of prostate cancer surgery, and between 10 and 70 more suffer serious complications.
– At least 200 to 300 of every 1,000 men treated with surgery or radiation suffer incontinence or impotence.
– 30 per cent of men who are treated for PSA-discovered prostate cancer suffer significant side effects from the resulting treatment.
Prostate cancer facts
The Canadian Cancer Society states that in 2011 an estimated 25,500 men in Canada will be diagnosed with prostate cancer.
On average, 70 Canadian men will die from prostate cancer every day.
Testing
There are two tests for prostate cancer:
(1) The doctor feels the prostate gland by inserting a finger in your rectum (this test is called a Digital Rectal Examination test or a DRE)
(2) A blood test called the Prostate Specific Antigen (PSA) test.
Symptoms
Men often do not experience any signs or symptoms of prostate cancer in its early stages. As the cancer develops, you may experience:
• A frequent and urgent need to urinate
• Difficulty in starting or stopping the urine flow or being unable to urinate
• A feeling that you are not able to completely empty your bladder
• A burning feeling or pain when you urinate
• Finding blood in your urine or semen
• Pain when you have sex (during climax).
Risk of getting prostate cancer
The following factors have a higher associated risk of getting prostate cancer:
• Age – men over 60. Prostate cancer is uncommon under 50 years old.
• Family history – if members of your family have had prostate cancer
• Being of African descent
• Obesity
• A diet high in fat
• Physical inactivity
• Working with cadmium, and to a lesser degree lead and copper, which are used in manufacturing.
With files from The Associated Press and the Canadian Cancer Society
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