By Dr. Fred Newton, Prostate Cancer Center,
An integral component of Urology of Central PA
as printed in 50plus Senior News September 2009
Should you test for prostate cancer or shouldn’t you? No doubt you’ve read or heard about recent studies questioning the advisability of PSA screening for prostate cancer.
In brief, some researchers are concerned that prostate cancer can be so slow growing that the prescribed treatment and side effects are often worse than the potential consequences of inaction.
However, should routine PSA testing be discouraged, one very perplexing dilemma remains: How can any unsuspecting patient know for certain if he harbors cancer cells, and if so, whether his particular cancer is slow growing or of the more aggressive type that can quickly become fatal if left untreated?
As urology specialists with a long track record of treating prostate cancer, the doctors at the Prostate Cancer Center firmly believe that PSA screenings remain essential to managing prostate health. Only when a “normal” baseline reading has been established (preferably at the age of 40) can your doctor watch for any dramatic jump in PSA readings which might indicate the need for further action. In fact, studies indicate that a two-point increase in the PSA level in one year can indicate an aggressive prostate cancer even though the new value is still normal or only mildly elevated.
This said, by no means do our physicians endorse the wholesale treatment of all prostate cancers. Indeed, some patients can postpone treatment indefinitely if monitored regularly … even though “active” treatment (vs. observation) of localized prostate cancer has been shown to reduce mortality rates. That is because some men, as they age, will fall prey to other diseases before a slow-growing prostate cancer becomes their primary threat.
An expert needs to differentiate between a “wait and see” case and one that requires urgent intervention. Armed with readings gleaned from PSA screenings (and follow-up tests as needed), our specialists help each patient to make fully informed decisions based upon their unique circumstances, including family history, age, general health, how quickly the cancer is likely to spread, etc.
The good news is that although the disease is potentially life threatening, a majority of prostate cancers are detected early and long-term survival is the expected outcome. That is why a PSA screening is so essential. Our experience has proven time and again that the strategy for managing prostate cancer must be aimed at early detection with “selective” treatment tailored to the individual patient.
Further studies have also recently affirmed that PSA testing does increase a doctor’s ability to detect early prostate cancer. PSA screenings have demonstrated a decreased risk of being diagnosed with metastatic prostate cancer (which spreads to other organs.) And since the advent of the PSA test, prostate cancer mortality in the United States has declined by approximately thirty percent.
When assessing your personal risks, it is important to remember that prostate cancer remains the 2nd leading cause of male-cancer deaths among American men over the age of 40 … and is especially prevalent among African American males.
In the end, we advise all patients to discuss the advisability of a PSA test with their doctor. As prostate experts, the specialists at the Prostate Cancer Center believe a PSA test remains a painless means of staying ahead of the curve when it comes to controlling your medical destiny.