To Screen Or Not To Screen, That Is The Question – PSA Test Under The Scope

For those of us who have prostates, the PSA Test is something that comes across our medical radar as we get older.

As with all medical issues (Disclaimer – I think there is a legitimate reason they refer to the medical community at-large as practicing medicine), I have always felt each and every person is unique and needs to make their own personal decision on whether or not to get tests, procedures, etc.  It is up to each and every one of us to solely determine our need and desire as to how deep we wish to go in being proactive, reactive or non-active regarding our short and long-term health prospects.  If nothing else these days, we own the right to our own bodies.

I have no problem going to see doctors if something is wrong with me.  I do not go to them to probe what might be wrong with me.

The genesis for my outlook on medicine will be covered in a future post.  For purposes of this one the bottom line is I’m not a big believer in prostate screenings…primarily because of that afore-mentioned part about practicing medicine.  Let’s continue with the understanding I’ve met and worked with a few great doctors…but I’ve also had quite the opposite experience.

The PSA Test is designed to head off potential prostate cancer by measuring the level of Prostate-specific antigen protein, which is produced by the cells of the prostate gland.  Recently, the U.S. Preventive Services Task Force, charged with assessing medical treatments and their reliability, has recommended routine, annual screening of older men with the PSA Test be ended.

In a recent USA Today editorial point/counterpoint, the argument was made for both retaining the current recommendation of yearly screening for men 50 or older…and ending them.  This independent panel determined after a decade of studies there is no clear evidence the test is saving lives…but there is ample evidence the level of screening has led to a level of harm.  Most everyone who has been screened with this test and found to have “something” chooses aggressive treatment…and the Task Force claims their evidence shows for every 1,000 men treated for screening-related issues five will die from surgical complications…anywhere from ten to seventy will have serious complications (and have to live with them)…and anywhere from two to three-hundred will develop urinary incontinence, impotence or both (and again, have to live with it/them).

This commission further presented findings one-third of men ages 40-60 and 75% of men over age 80 have cancer cells in their prostate.  Dr. Virginia Moyer, chair of the Task Force, offered, “Most prostate cancers detected by screening do well with no treatment, and treatment can cause harm.  It is the small proportion of men with aggressive cancers who might have their lives prolonged by screening, but this benefit has not been demonstrated, and the PSA Test is not good at distinguishing aggressive from indolent cancer.”

The USA Today editorial staff presented the obvious counterpoint, headlined “If PSA Test Saves Lives, Averages Don’t Matter.”  That’s a no-brainer if you or your loved one is a person who gets screened, believes in aggressive treatment as necessary and comes out “the other side” thinking their life has truly been saved.

This is assuming your quality of life from the “life-saving” treatment remains intact.  I have heard stories from the field that make me wonder “if they had to do it all over again…?”

Would these men have been just fine leaving well enough alone?

The same group recommended a rollback on mammograms in 2009.  Many who practice medicine were beside themselves.  USA Today’s support for leaving things as they are with regard to the PSA Test ended with, “Being left in the dark – whether by choice or medical fiat – is not a helpful option.”

Clearly they have missed – or chosen to miss – the central point of the Task Force’s opinion…in my opinion.

You are still in the dark after the screening. 

You don’t know what the findings mean relative to whether or not treatment is actually necessary.

It’s up to each man to make his own decision what to do regarding the PSA Test.  It’s your right.  It’s my right.  No one should be made to feel they are doing anything wrong just because those who practice medicine think they know what is best for you, one way or the other.

You make the call as to how much you want to know.

Just keep in mind…no one knows.


About sportsattitudes

I'm Bruce. Born, raised and still outside the City of Brotherly Love. Managed (so far) to visit a dozen of our United States and Canada (twice). Addicted from birth to Television/Movies/Sports. Took three years of French and got credit for two of 'em.
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2 Responses to To Screen Or Not To Screen, That Is The Question – PSA Test Under The Scope

  1. Great post today; there IS a reason medicine is a science. While I have been fortunate to cone across some find doctors in my life, it is always important to colloborate with your doctor rather than giving them sole authority over all decisions and treatments.

    Bravo, well done!


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