Prostate Cancer Seen in Younger Men
Nevertheless, "A consequence of screening is that you're going to overtreat the disease," says Gerald Chodak, MD, of the University of Chicago. "We run the risk of doing a lot of harm to people."
Prostate cancer treatment -- surgical removal of the prostate or radiation therapy -- can leave a man impotent or incontinent. If you're 50 years old and in otherwise good health, you might spend the next two decades dealing with those consequences. A less compelling argument to patients, but a dear one to the healthcare industry, is that screening and treatment cost a lot of money, which may turn out to be wasted if deaths are not prevented in the long run.
"I would rather be in this position than the other," says Paul Lange, MD, of the University of Washington in Seattle. He says he's in favor of screening because he would feel awful if he didn't screen his patients, should doing so eventually be proven to save lives.
Another study presented this week suggests that it's good to screen. Researchers in the Netherlands compared the number of cancers found in men who took part in a screening program with the number found in men who saw a doctor only after developing prostate cancer symptoms. They looked at the cases of more than 35,000 men aged 55 to 74 and found that screening detected 818 cancers, whereas only 150 were diagnosed without screening.
In addition, among the men who were not regularly checked, close to 7% had cancer that had spread beyond the prostate gland -- compared with less than 1% of those who had been screened.
But even if regular prostate checkups are warranted, maybe they're being done too often. "When we began screening for prostate cancer we did it every year," says E. David Crawford, MD, of the University of Colorado. "We didn't know any better."
Crawford presented a study this week that looked at the time it took for men's PSA levels to rise into the danger zone. A PSA level of less than four is considered normal. When it goes over that, there may be a tumor.