Perhaps you heard that last week the US Prevention Services Task Force said that healthy men should no longer be screened for prostate cancer. The recommendation is a draft, and it is generating a lot of controversy and confusion.
While detecting cancer early is generally a very good thing, prostate cancer is complicated. The tests (a blood test for prostate specific antigen, or PSA and digital rectal exam – DRE) certainly can detect cancers. The problem with early detection is that 1) as many as 40% of the cancers detected are so slow growing that they are not thought to produce a real threat; and 2) treatment for prostate cancer can be really invasive and may have side effects that include incontinence and impotence.
Put another way: positive test results may lead physicians to recommend unnecessary treatment that often damages a man’s life.
The American Urological Association expressed fear that these recommendations could do more harm than good and called for continued screening. Early detection of aggressive prostate cancer can be a lifesaver.
This is the sort of controversy that drives us all a little crazy – especially men, who often hate going to the doctor, hate talking about cancer, and hate digital rectal exams. If all you do is read the headlines, you have probably found yourself feeling at least a little confused and/or anxious about all of this. If the test makes you anxious and “the experts” say that you might not need it, denial suddenly looks like a good option.
It isn’t. Headlines are no substitute for informing yourself and taking time to talk with your physician. An excellent place to start informing yourself is by looking at what the Mayo Clinic has to say about prostate cancer.
What to do? Here’s what seems to be emerging:
- Routine testing is a good idea if you’re at risk – if you have a family history of prostate cancer, for instance.
- If you have no history of cancer and aren’t thought to be particularly at risk, talk about the pros and cons with your physician.
- Denial isn’t helpful. Neither is rushing to make a decision, either about testing or about treatment.
- There are many options available for treating prostate cancer. Because treatment can have a big impact on sexual functioning, don’t make a decision until you’ve gotten a second opinion and have done enough research to understand which treatment options are best for you.