Bring Back Prostate Screening

Here's a recent NY Times article by a urologist who favors a return to prostate screening. I agree

www.nytimes.com/2015/07/06/opinion/bring-back-prostate-screening.html?ref=health&_r=0

Thank God my husband's GP believed in screening!

Thanks for posting that Tim, they make a great case.
The one downside they don't address, unless I missed it, is the anxiety that PSA causes, even in healthy men. Of course, if there was no screening, a lot of us would have already met our demise,, and wouldn't have anxiety at all. So that's the best argument, paradoxically, for screenings.

The recommendation to not screen in "low risk" men, is probably the most assenine thing I've ever seen a committee come up with, next to the recommendation agains mammograms.

Good article! Totally agree!

One wonders how much of the 'no more screening' recommendations are about money? Screening doesn't provide profits. Late stage treatments generate large sums of money.

This article makes a lot of sense, and fits with what I've been thinking about the whole overtreatment argument. That the way to reduce overtreatment is to get better at diagnosis and determining which situations really need treatment. Along with doing lots better at patient education.

I tell everyone I know that they need to get screened annually from age 40 onwards. Sadly it's an uphill battle and I just don't understand why they are so reluctant. No one, and I repeat know one that I've spoken to, has a urologist. Kinda scary but won't stop me trying - if even one person is helped it is worth it.

these guys who are reluctant to be screened, and I was one of them, only hear "PSA tests don't work" and the "advocates" and insurance companies laugh all the way to the bank.

ed

It always seems to come back to the GPs and whether or not they are paying attention or even know enough to pay attention. They are the ones who will have to educate and fight the insurance companies to provide screening for asymptomatic men. Like Duke and so many others, Gary's GP didn't order the test, even when he had symptoms for three full years AND was obviously failing physically. I try not to go there mentally...makes me too angry.
Beth

I am no expert, only the victim's wife, so I need to rebut the rebuttal

First, I fail to see "harm" coming to a patient from a simple blood test to establish a baseline after age 40. If baseline psa tests lead to more unnecessary biopsies, that's another subject altogether. The article suggest waiting for the newer tests to be perfected while having men do "nothing" to screen for prostate cancer. The medical community advocates for much more invasive and dangerous colon cancer screening for every patient or cholesterol tests (also far from perfect for diagnosis of heart disease) would lead me to believe that the medical community and insurance companies are not taking the threat of prostate cancer seriously.

The statistic that there have been more identified cases of aggressive cancers since the screening process has been downplayed is certainly believable. Also believable that mortality rates have decreased in the short time frame being scrutinized, as all the newer PCa drugs are successfully prolonging life, but the cost of these treatments are phenomenal!
Waiting around too see if more people are dying from lack of screening feels like a slap in the face to those of us who are suffering and advocating for early detection.

Lastly, this article concedes that patients who worry about it should have the right to insist upon the test. Are you kidding??? All other routine screening is just ordered by the GP, but this particular test has to be begged for? So many on this forum with G9 and extensive mets tell the same story as ours. The GP screwed up and didn't notice the elevated PSA or didn't follow up the DRE or didn't do the DRE or misdiagnosed the problem.

Bring back Prostate Screening!

Beth for Gary

FYI, the NCCN released new screening guidelines for physicians last week, version 2.2015. You can get a free account to download these.

http://www.nccn.org/professionals/physician_gls/pdf/prostate_detection.pdf

Here's my thought on the PSA as a diagnostic tool - if you never get Pca it's not necessary. Simple, right? Now we just need to figure out who will get Pca and who won't and screen just those who do. Wouldn't that just be a tidy solution?? Seriously, the insurance companies need to loosen up and provide it for anyone who requests it, and docs need to learn how to use it. I was lucky, in a way, that my father passed away from it so I knew it was coming and watched out for it. Even so, there was no quick elevation in PSA - it actually went from 5.1 in Dec 2013 to 4.4 in Dec 2014 - but because of my dad's experience I'd been having the DRE for several years and that was where we caught it. Do the PSA to establish a baseline - if there is a significant increase (or a small increase but a family history of Pca) go get a DRE done (as uncomfortable as it is, it's a life-saver) by a urologist who has a lot of experience with Pca and LISTEN TO HIM/HER. I've been so lucky to have such excellent medical care here in Houston, TX, but I know it's not like that everywhere.