In addition to today’s resource, please review the following:
- Who Should We Screen For Prostate Cancer With The Prostate Specific Antigen (PSA)
Posted on September 21, 2024 by Tom Wade MD
All that follows is from the article, Too Many Older Men Are Still Screened for Prostate Cancer*. By Paula Span. May 8, 2023
*This is a link to subscribe to The New York Times. It is not an affiliate link. I just think that the New York Times is an outstanding resource.
Most have low-risk cancers and rarely benefit from treatment, a new study finds. Actively monitoring the condition is often the best choice.
Last summer, Joe Loree made an appointment to see his urologist. He’d occasionally noticed blood in his urine and wanted to have that checked out. His doctor ordered a prostate-specific antigen, or P.S.A., test to measure a protein in his blood that might indicate prostate cancer — or a number of more benign conditions.
“It came back somewhat elevated,” said Mr. Loree, 68, an instructional designer who lives in Berkeley, Calif. A biopsy found a few cancer cells, “a minuscule amount,” he recalled.
Mr. Loree was at very low risk, but nobody likes hearing the c-word. “It’s unsettling to think there’s cancer growing within me,” he said.
But because his brother and a friend had both been diagnosed with prostate cancer and had undergone aggressive treatment that he preferred to avoid, Mr. Loree felt comfortable with a more conservative approach called active surveillance.
It typically means periodic P.S.A. assessments and biopsies, often with M.R.I.s and other tests, to watch for signs that the cancer may be progressing. His hasn’t, so now he can get P.S.A. tests every six months instead of every three.
Research shows that a growing proportion of men with low-risk prostate cancer are opting for active surveillance, as medical guidelines now recommend.
The diagnosis used to lead directly to aggressive treatment. As recently as 2010, about 90 percent of men with low-risk prostate cancer underwent immediate surgery to remove the prostate gland (a prostatectomy) or received radiation treatment, sometimes with hormone therapy.
But between 2014 and 2021, the proportion of men at low risk of the cancer who chose active surveillance rose to nearly 60 percent from about 27 percent, according to a study using data from the American Urological Association’s national registry.
“Definitely progress but it’s still not where we need to be,” said Dr. Matthew Cooperberg, a urologic oncologist at the University of California, San Francisco, and lead author of the study.
