Many have been asking about when and even whether men should have PSA (Prostate Specific Antigen) tests to screen for prostate cancer or even possible prostate cancer. PSA tests can yield false-positive readings on the level of a protein produced by the prostate gland in a man’s blood. This can lead to biopsies that have their own potential risks, like bleeding, pain, and infection.
So to screen or not to screen? It’s a question I have my own personal opinion on, and the reason two articles recently caught my attention. The first was a report in an April 11 issue of Medpage Today headlined “USPSTF Backs Individualized PSA Screening.” The second was an April 12 report on the same study in The Washington Post headlined “Panel reverses course on screening for prostate cancer.”
The study – by the U.S. Preventive Services Task Force – doesn’t so much recommend for or against the test as it suggests that men between ages 55 and 69 should at least have a discussion about the potential benefits and risks with their doctors. It’s an individual decision, in other words. According to these articles, some 3 million American men are currently living with prostate cancer. More than 161,000 more will be diagnosed this year and almost 27,000 will die from the disease.
My own experience with prostate cancer and PSA testing included one false-positive biopsy (with no side-effects thankfully) and a second one that came up positive for early-stage cancer. That was 10 years ago.
Because prostate cancers tend to be slow growing, if caught early they say they may never pose a serious health threat. That I may die from something else before cancer actually harms me. One option, therefore, is what’s called “watchful waiting” or “active surveillance,” meaning do nothing right now, but continue to monitor it with regular PSA testing, rectal exams and, if needed, biopsies. This would require tracking appointments and keeping an accurate record of diagnosis. That’s easy with a reliable mobile health app. The other two options are radiation or surgery, both of which carry risks of urinary incontinence and impotence.
In my case, I didn’t feel comfortable with “watchful waiting.” After talking with my doctor, reviewing my biopsy results with surgeons and radiation oncologists, and talking with my wife and friends, I opted for external radiation treatments — 24 treatments over five weeks.
Happily, the radiation worked, though I still have an annual PSA test, just to be sure it doesn’t recur. So I definitely favor screening.
What do you think? Share your opinion. Both articles, though, will give you some statistics on the risks and benefits that are worth considering as you form your own opinion.