New Guidelines for Prostate Cancer Screening

March 8, 2010 by  
Filed under health

I’m about to make an appointment for my yearly physical. This year is especially important because I just turned 50. I could not help but to notice about new guidelines that were issued last week on prostate cancer screenings that emphasize that physicians should better educate men about both the risks and benefits of using the PSA test for screening. (I got this information from the LA Times)

They also call for cutbacks in the use of digital rectal exams to find tumors and recommend the end of mass prostate screening programs at health fairs and other sites. The revised guidelines issued by the influential American Cancer Society come on the heels of several studies suggesting that large numbers of tumors identified by PSA screening are inconsequential and that biopsies and treatment produce more harm than those tumors would.

Because of such findings, the new guidelines emphasize the importance of physicians explaining both risks and benefits to the patients more fully so that each man can make an informed decision about whether to get tested.

Otis W. Brawley, chief medical officer of the American Cancer Society, said the new guidelines are not that different from earlier ones issued in 1997 and 2001. “I think (earlier panels) meant to say what we are saying now, but they were interpreted by people to say we were encouraging screening,” Dr. Brawley said. “They were trying to encourage informed decision making.”

Skip Lockwood, president of Zero: The Project to End Prostate Cancer, said that calls to end the digital rectal exam are “kind of nuts. … The whole concept that you would do anything to reduce the amount of information you have does not make sense to me.

Prostate cancer is the most common cancer in men after skin cancer, affecting 192,000 men each year and killing 27,000. And while all the parties may not totally agree on how and how often PSA screening should be used, they are in unanimous agreement on one point. As Mr. Lockwood said, “We need a better test.”
After reading this information, I ask myself “What am I going to do?” I think I will ask my doctor. And what about you? I would love to hear from other men out there about what they think or what they plan to do.

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2 Responses to “New Guidelines for Prostate Cancer Screening”
  1. Joseph Getchel says:

    Well, the ACS strikes again!  Would the authors of these new guidelines say the same about screening (PSA & DRE) if they were in a high-risk category?
    Because of detection at 49 (PSA & DRE screening), I have been free of cancer for 11 years.  I know of another individual who was just diagnosed at 65 (had not had prior screening), and is now having to go through salvage Radiation Therapy, because they did not catch the cancer soon enough.
    How many men have to die of Prostate Cancer, who could have been diagnosed early enough to be effectively treated, before these guidelines are reversed/revised? 
    There is anecdotal evidence that the number of men dying of Prostate Cancer has dropped since the introduction of the PSA Test, while the number of detected cases of PCa has risen (why doesn’t the ACS do a scientific study?).

  2. Robert Hess says:

    From my perspective as an accidental prostate cancer survivor, I believe we lack the detailed statistics to set the testing standard so late in life, especially when we lose almost 29,000 each year to prostate cancer, over a million men since the War on Cancer was declared in 1971.  Personally, my cancer was diagnosed at stage T2C when my PSA was 3.2 and a negative DRE – I had two tumors sitting on top of the prostate where they could not be felt during a DRE.  My urologist used a simple Free PSA test, which is hardly ever mentioned, to determine there was a highly probability of prostate cancer present.  Two series of needle biopsies later the cancer was found.
    The constant focus on potential treatment side effects causes men to be even more reluctant to think about prostate cancer.  What we need is more balanced education about prostate cancer so that men can make good treatment decisions.  Trying to learn about prostate cancer after you have received a diagnosis is highly stressful.  It’s not knowing you have cancer that causes over treatment, it is more a function of not knowing if you have an aggressive form of the disease and a clear picture of the full range of treatment options, along with genuine statistics about the potential side effects of each option.
    I will be crossing the US and back this summer by motorcycle to raise men’s awareness of prostate cancer.   Our route details are posted at  I would enjoy meeting people at stops along the way – 24 states and 46 days.
    Robert Hess
    President/Prostate Cancer Survivor
    Prostate Cancer Awareness Project
    Manhattan Beach, CA

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