Do Not Stop The PSA Test For Prostate Cancer Screening. Instead, Recommend It For Even Younger Men Too.

     One in six American men will be diagnosed with prostate cancer at some point in their lifetime.  That being said, one of the most controversial topics in health care today is whether men should get routine prostate specific antigen (PSA) tests to screen for prostate cancer.

     The United States Preventive Services Task Force has issued recommendations against the PSA screenings for males of any age.  The government advisory task force panel explained its opposition stating that, although results of a PSA test may be the reason a doctor performs a biopsy and ultimately discovers that a patient has prostate cancer, many of the malignancies would never have done the man - who has been diagnosed - any harm.  The panel also concluded that prostate biopsies can lead to infections and that treatment for prostate cancer - such as the radical prostatectomy surgical procedure - can leave a man with post-operative complications such as erectile dysfunction and/or incontinence; and that treatment for prostate cancer can, in some cases, lead to death.  But despite the task force panel's advice, lives are, in fact, saved as a result of the PSA test.  To me, it doesn't make much sense to not recommend a test that could save people's lives.  In fact, some doctors believe the PSA test can indeed save lives.  The question that I have is - why will certain doctors on one hand say the PSA test is beneficial, but on the other hand the same physicians will say it's a waste of time and money?  It's difficult to comprehend why any professional medical expert would suggest that the PSA test is a lifesaving method of cancer screening, while also indicating that there are no benefits for the test.  The contradiction is mindboggling and quite puzzling.

     Major League Baseball's Joe Torre and former New York City Mayor Rudolph Giuliani are among tens of thousands of men in the United States who believe a PSA test saved their lives. 

     And Dan Zenka, who is senior vice president of the Prostate Cancer Foundation, says his organization supports widespread PSA testing.  Zenka, a prostate cancer survivor himself, says of the PSA test, "I can tell you it saved my life."

     Although some doctors agree that the PSA test is not necessary, other physicians believe that testing, beginning at age 50, is essential.  Personally speaking, I disagree with both schools of thought. 

     As a prostate cancer survivor of nearly 18 years, I was 38 when my doctor first suspected that I had the disease.  I was 40 when I was formally diagnosed and underwent treatment.  Therefore, if I had waited until age 50 before I was given a PSA test, there is not only a distinct possibility, but a distinct likelihood - according to many doctors I've consulted with - that I'd be dead today.

     I will turn 58 on February 1st.  It irritates me to no end that health insurance companies refuse to pay for certain tests and procedures - such as the PSA test for men and mammograms for women - if the patient doesn't fall in to a certain age group.

     For an American male, the lifetime risk of developing prostate cancer is 16 percent, but the risk of dying of prostate cancer is only 2.9 percent.  Such statistics by the American Cancer Society suggests that prostate cancer often grows so slowly that most men will die of other causes before prostate cancer becomes advanced and fatal.  Still, prostate cancer is second only to lung cancer as the leading cause of cancer deaths in men in the United States.

     As the old saying goes, "I'm not a doctor and I don't play one on TV" - but I believe every man should be given his first PSA test at no older than age 35.  And if there's family history in a young relative, then blood should be drawn for screening by age 30.

     I understand that my opinions about the PSA test are purely personal, as I have no medical background.  But, as one who has experienced prostate cancer first hand - and as I noted above - was suspected of having the disease at age 38 - why not at least learn if a man has an overly high PSA level when he is younger than age 50?

     If a man who is 35 - or younger - is given a PSA test - and an elevated PSA level is detected - his life could be saved.  If he wasn't given that PSA test until age 50 - and he actually had cancer for many, many years - by the time a malignancy is discovered, the cancer may have spread to other areas of his body; and once that cancer has metastasized, the patient's life expectancy is bound to be shortened and treatment will likely be an effort in futility.  It, therefore, seems obvious to me that the chief reason for a reduction in advanced cases of prostate cancer is the PSA test.

     As for the PSA levels, doctors will generally say that anything below 4.0 is nothing to worry about.  Sure...if a man is 70 or 80...that is perhaps true.  But if a man is younger - especially one who is 40 or even younger than that - a level below 4.0 may be a great need for concern.  After all, there's numerous documentation that shows men with PSA levels of 20.0 who do not have prostate cancer, while others with 2.0 levels that do have the disease.  For that reason, I fully understand that the PSA test is not always an accurate method of detecting prostate cancer.

     However, there is no reason to stop the PSA test and no reason not to give the PSA test to men of any age - including younger men.  Oh I know what some of you are saying - "Who's going to pay for it?"  When it comes to saving people's lives - should we really be putting a price tag on it?  If the man was your father...your son...your brother...your uncle...even your elderly grandfather...would you want him to die when his life could have been saved by a PSA test and medical treatment? 

     More than 28,000 men die of prostate cancer each year in the United States.  That's about one man in 36 who will die from the disease.  Used correctly, the PSA test is invaluable.  If screening is abandoned, then there will certainly be men who will miss their chance for cure and that number of 28,000 will more than likely go up and up and up.

     Today, treatments for prostate cancer are not as invasive, in some cases, so that men do not always have to suffer through lengthy hospital stays and post-operative complications.  I am convinced, beyond a shadow of a doubt, that the PSA test saves lives; and that not only older men can benefit from the test, but younger men - perhaps as young as those in their thirties - will as well.

     Not giving a man a simple blood test should not be the reason why he is not screened for a deadly disease such as prostate cancer.  A little bit of blood TAKEN today...could GIVE someone their life tomorrow - and for many tomorrows to come.

     And that's The Controversy for today.

     I'm Gary B. Duglin.

Copyright 2013 Gary B. Duglin and TheControversy.net. All Rights Reserved.

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