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Why get your PSA screened?
July 8, 2010
Recently, the television, print and internet media has been running stories about prostate cancer screening recommendations published by the American Cancer Society. We realize that all of this information can be confusing, however, as the only medical group focusing on all aspects of prostate care in the Willamette Valley we would like to help you understand what this all means.
The American Cancer Society is urging doctors to:
1. Discuss the pros and cons of testing with their patients, including giving them written information or videos that discuss the likelihood of false test results and the side effects of treatment.
2. Stop performing the rectal exam as a standard prostate cancer screening because it has not clearly shown a benefit, though it can remain an option.
3. Use past PSA readings to determine how often follow-up tests are needed and to guide conversations about treatment.
The Oregon Urology Institute applauds the American Cancer Society (ACS) for its new guidance statement on prostate cancer detection. We agree that a discussion between physician and patient about the risks and benefits of testing is a key part of one's decision to be tested for prostate cancer. Prostate Cancer testing is an individual decision that patients should make together with their doctor. The Oregon Urology Institute also agrees with the American Urological Association that all men, with a life expectancy of 10 years or more, should
1. Have a baseline PSA test at the age of 40.
2. Determine with their physician rescreening intervals based on PSA results.
3. Determine the need for a prostate biopsy based not only on elevated PSA and/or abnormal DRE results, but on additional factors such as free and total PSA, patient age, PSA velocity, PSA density, family history, ethnicity, prior biopsy history and comorbidities.
Where we disagree with these guidelines is with the value of routine screenings for early detection of prostate cancer. Our experience tells us that cancer detected by PSA screening is associated with a lower chance of being in an advanced stage or to be metastasized to other areas of the body. Our professional literature also shows that in one study that routine screenings decreased incidences of death from Prostate Cancer by 20% over a nine year period.
We believe that the real issue is not the actual screening but what is done with the results from that screening. Each person is different and requires an individualized plan. That's why the Oregon Urology Institute came together in the first place. We believe in the tried and true philosophy that an individualized approach to assessing risk, considering that risk and developing treatment strategies based upon that risk benefits people best. That's why we have made the commitment to provide each patient with a wide variety of care options and to work with each patient to develop a treatment plan that meets their individual needs.
~ The Physicians of Oregon Urology Institute
Source: OUI
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