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PSA-Based Screening for Prostate Cancer? Task Force Recommends Against 

 January 28, 2013

By  Dr. Tripp Stover, D.C.

blood-test-200-300Mechanicsville Virginia Chiropractor – Prostate cancer is the second most common form of cancer in men after skin cancer.  If you are male and you live to middle age you will have prostate “issues.”  Not necessarily cancer, but conditions ranging from prostatits, frequent trips to the bathroom at night, to benign prostatic hyperplasia (BPH).  Cancer is, of course, what men fear, and rightly so.

The American Cancer Society estimates that approximately 1 in 6 men will be diagnosed with prostate cancer at some point during his lifetime.  The risk increases with age, with 80 percent of cases being diagnosed in men over age 65.  In fact—if you live long enough—almost all men will eventually develop prostate cancer.  It is generally slow-growing and most men will die (usually from some other cause) without ever knowing they had it.

The prostate-specific antigen (PSA) test is what is most commonly used to screen for prostate cancer.  However, the usefulness of this test in relation to how many lives it actually saves has been disputed for the last few years.  In May 2012, the United States Preventive Services Task Force (USPSTF) released its final recommendations regarding PSA screening and now recommends that all men do not get routinely screened for prostate cancer.

The recommendation, which was published in the journal of the American College of Physicians, the Annals of Internal Medicine, is based on evidence that the harm that results from PSA testing outweighs the benefits received, regardless of age.  Obviously, the goal of cancer screening of any type is to save lives.  However, the results of U.S.  trials showed no reduction in mortality with PSA screening, and European trials showed a reduction of only approximately one in a thousand men aged 55 to 69 years.  In addition, PSA screening was associated with considerable harm.

In nearly 90 percent of cases in which men were diagnosed with prostate cancer by a PSA screening, early treatment using surgery, radiation or androgen deprivation therapy was performed.  This often leaves men incontinent, suffering from erectile dysfunction and sometimes bowel dysfunction for the remainder of their lives.  Furthermore, up to five in 1,000 men will die within one month of prostate cancer surgery.

The Task Force’s recommendation, however, does not please everyone.  Dr. Henry Lynch, Director of the Hereditary Cancer Center at Creighton University (co-author of an editorial accompanying the recommendation) believes that the advice will return men to a time when prostate cancer was discovered at a more dangerous, advanced and incurable stage.  It also does not take into account screening for younger men and men at higher risk.  Lynch noted, “My colleagues and I strongly believe that the Task Force recommendations should not be used as justification by insurers, including Medicare, to deny diagnosis of prostate cancer to the male population at risk.”

However, in the view of Otis W. Brawley, MD, MPH, Chief Medical Officer of the American Cancer Society, many men have had prostate cancer detected that may never have progressed significantly in their lifetime, leading to unnecessary intervention.  Brawley said, “Many people have a blind faith in early detection of cancer and subsequent aggressive medical intervention whenever cancer is found.  There is little appreciation of the harms that screening and medical interventions can cause.”

Wisdom on both sides of the debate to be sure.  In the end, early detection is not prevention.  It is foolish to think any testing, early or not, is going to prevent a disease.  If a test finds it, you have it.  Please do what you can to reduce your risks for disease and pick up some healthy lifestyle habits to increase wellness.

I’ve got your back,Logo

Dr. Tripp Stover

Stover Chiropractic, P.C. –  Real. Simple. Healthcare.

www.drtrippstoverblog.com

Spine-Health.com

www.TrippStoverDC.com

 

Location:

We are located at 9097 Atlee Station Road in Mechanicsville, Virginia, 23111.  This is a Hanover county address, but we are minutes from Glenn Allen, Innsbrook, Sandston, and Varina.  We also serve many people from King William and New Kent Counties.  Our close proximity to I295 means we are very easy to reach from anywhere in the Richmond Metro area.  Contact us: 804-599-1100

 

 

 

Dr. Tripp Stover, D.C.


Dr. Stover grew up in Richmond. He has been married to his wife Andrea since 2000 and they make their home in Mechanicsville with their children, Avery and Garnett.

Dr. Tripp Stover, D.C.

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