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Is Prostate Cancer Screening Still Necessary?

The current test for prostate cancer continues to spark debate. In part 1 of WebMD's 2-part series, there's important prostate cancer information that men should have.
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The Prostate Cancer Biopsy: Your Ultimate Diagnostic continued...

The method of notating this measurement is called the Gleason score, and it ranges from 2 (known as an incidental cancer and probably slow growing) to 10 (which indicates a highly aggressive cancer with imminent health threats).

But as effective as the biopsy can be in determining both risks and treatment choices, Lepor points out that it doesn't always render clear-cut results.

"It's entirely possible for the sampling to pull up cells that indicate only a moderate or even incidental cancer when right next door there could be more aggressive cells," he says.

If the decision is then made to remove the prostate, and no more aggressive cells are found, then the surgery might have been unnecessary. But at the same time, he says, not doing the surgery -- and missing the aggressive cells -- could mean death.

But rather than blame the PSA for the unnecessary procedures, both Hall and Lepor say it can aid in making the right treatment decision.

"While the PSA does not yield a cancer diagnosis on its own, together with other pieces of information it forms a risk profile, and it is that risk profile that can be very important when determining an individual man's course of treatment," says Hall.

To Screen or Not

In fact, despite controversy, most doctors agree the PSA remains an important and necessary diagnostic tool.

In addition to the ACS report, Hall adds that "there is no question that since the PSA era the two things that have changed are fewer men are diagnosed with metastatic cancer, and we have seen a decrease in the mortality rate from prostate cancer overall, all because we are picking up the cancers earlier."

The question remains, however, is who needs testing the most, how often, and when? Today, most doctors agree it's a patient-by-patient decision, with only the most flexible guidelines to follow.

One factor that is important for all men, however, is their age. But if you're thinking the older you are, the more you need this test -- guess again.

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