A New Study Claims Prostate Cancer Screenings Significantly Reduce Deaths. Not Everyone Agrees

Excerpt:

“An analysis of two influential studies of prostate cancer screening concludes that the much-debated test “significantly” reduces deaths from the disease, suggesting that current recommendations against routine PSA screening might be steering men away from a lifesaving procedure.

“The analysis, published Monday in Annals of Internal Medicine, drew wildly different reactions, as is often the case with research on PSA screenings. Some experts in cancer screening and statistics said its novel approach was “on shaky ground” and used a “completely unverifiable” methodology that they had “never seen before,” but others praised its “intriguing and innovative approach.” There was one area of agreement, however: “I imagine it’s going to generate some buzz,” said biostatistician Ted Karrison of the University of Chicago.”

Go to full article.

If you’re wondering whether this story applies to your own cancer case or a loved one’s, we invite you to use our ASK Cancer Commons service.


New Prostate Cancer Tests Aim to Reduce the Death Rate

Excerpt:

“About a dozen new medical tests are coming to market that aim to more accurately diagnose prostate cancer and go well beyond the standard PSA (prostate-specific antigen) blood screenings used today. Several of them may even allow men to forego getting a biopsy that more than 1 million men diagnosed with prostate cancer undergo each year. That’s because these new tests will help doctors distinguish between aggressive disease and slow-growing tumors.”

Go to full article.

If you’re wondering whether this story applies to your own cancer case or a loved one’s, we invite you to use our Lifeline service.


Treat or Monitor Early Prostate Cancer? 10-Yr Survival Same

Excerpt:

“Men with early prostate cancer who choose to closely monitor their disease are just as likely to survive at least 10 years as those who have surgery or radiation, finds a major study that directly tested and compared these options.

“Survival from prostate cancer was so high—99 percent, regardless of which approach had—that the results call into question not only what treatment is best but also whether any treatment at all is needed for early-stage cases. And that in turn adds to concern about screening with PSA blood tests, because screening is worthwhile only if finding cancer earlier saves lives.”

Go to full article.

Do you have questions about this story? Let us know in a comment below. If you’re wondering whether this story applies to your own cancer case or a loved one’s, we invite you to use our Lifeline service.


Increasing the Odds of Prostate Cancer Detection

Excerpt:

“For three years, Andrew Harder wondered if he had prostate cancer. In 2009, he had routine blood work that revealed an elevated prostate-specific antigen (PSA) level. When PSA is above 4 nanograms per milliliter of blood, it can be one of the first signs of a prostate tumor. Harder’s PSA was 9.

“By the time Harder saw a urologist, it had skyrocketed to 20. His doctor recommended the traditional next step: a transrectal ultrasound (TRUS) biopsy, which involves taking random tissue samples from 12 cross sections of the prostate.

“Over the course of two years, Harder, 60, an MRI technologist, would have three TRUS biopsies. They were all inconclusive.”

Go to full article.

Do you have questions about this story? Let us know in a comment below. If you’re wondering whether this story applies to your own cancer case or a loved one’s, we invite you to use our Ask Cancer Commons service.


Flawed Study of Advanced Prostate Cancer Spreads False Alarm

Excerpt:

“Bad news for men popped up in news media all over the country this week, based on a study from Northwestern University reporting that cases of advanced, aggressive prostate cancer had risen sharply from 2004 to 2013.

“Newsweek, NBC, CBS, Fox News and United Press International were among the organizations that covered the study. The reports suggested that recent medical advice against routine screening might be to blame for the apparent increase in advanced cases, by leading to delays in diagnosis until the cancer reached a late stage. Another factor cited was the possibility that prostate cancer had somehow become more aggressive.

“But the frightening news appears to be a false alarm — the product of a study questioned by other researchers but promoted with an incendiary news release and initially reported by some news media with little or no analysis from outside experts.”

Go to full article.

Do you have questions about this story? Let us know in a comment below. If you’re wondering whether this story applies to your own cancer case or a loved one’s, we invite you to use our Ask Cancer Commons service.


NewYork-Presbyterian and Weill Cornell Medicine Urologists Urge Reconsideration of Prostate Cancer Screening After Finding Critical Flaw in Landmark Study

Excerpt:

“Evidence now favors that prostate specific antigen (PSA) testing can help reduce the number of fatal cases of prostate cancer, contrary to earlier recommendations based on a landmark national study. Researchers from NewYork-Presbyterian and Weill Cornell Medicine discuss their findings related to PSA screening in this week’s New England Journal of Medicine.

“In their letter to the editor, published May 5, the investigators question the results of a large-scale clinical trial assessing the value of PSA screening — which served as the basis for the U.S. Preventative Services Task Force’s 2012 recommendations against routine prostate cancer screening. They say limitations in the study’s methodology underscore the need for healthcare policy leaders to reevaluate the nation’s approach to PSA screening.

“Prostate cancer remains the second leading cause of cancer death among American men and is the most common cancer in men other than skin cancer.”

Go to full article.

Do you have questions about this story? Let us know in a comment below. If you’re wondering whether this story applies to your own cancer case or a loved one’s, we invite you to use our Ask Cancer Commons service.


PSA Screening Leads to Overtreatment of Low-risk Prostate Cancer Says Long-Term Study

“A paper published in the Journal of Clinical Oncology, authored by Tosoian et al, reports on the long-term outcomes of prospective active surveillance (AS) of patients with favorable-risk prostate cancer.

“The authors point out that the common widespread practice of screening for prostate cancer in the United States, using prostate-specific antigen (PSA), may have led to overdiagnosis and overtreatment of the disease.

“The US Preventive Services Task Force has issued a grade D recommendation to reduce the use of PSA screening, and the National Institutes of Health has made a study of the outcomes of AS a research priority as well.”


Questioning Medicine: Prostate Cancer Screening (CME/CE)

“As prostate cancer awareness month just ended, prostate cancer screening seemed a fitting subject for this week’s blog.

“Those who know the evidence might think this argument pits European practices against our own domestic actions. Almost like a Ryder Cup for prostate screening. However, I recently saw that almost 50% of patients admit to undergoing lubed finger insertions and blood tests, which we know to be fairly inaccurate, in the last 12 months.

“In a Research Letter in JAMA Internal Medicine by Sammon et al., the fact that so many physicians are still screening for prostate cancer makes my evidence-based medicine soul cringe. In a 2012 survey, the authors found that among 114,544 respondents, 37% had undergone screening. Higher socioeconomic status nearly doubled a man’s odds of being screened (odds ratio 1.91, 95% CI 2.69-3.34).

“Prostate cancer screening has been placed in the no-go category by the U.S. Preventive Services Task Force and the Choosing Wisely campaign, as well as by many other major medical associations.

“Even the American Urological Association, which stands to lose the most money from reduced screening, states, ‘Men ages 55 to 69 … should talk with their doctors about the benefits and harms of testing ….’ In my opinion, they deserve a standing ovation for speaking to the evidence and not to the money, as the American College of Obstetrics and Gynecologists has with pelvic exams.”


Talking to Men About PSA Testing

“My patient looked back at me with a blank stare. I had just finished my take on the pros and cons of having a PSA test, and he looked lost. ‘What would you do if you were me, Doc?’ he said. I had just finished explaining the decision every man faces when he turns 50: whether to be screened for prostate cancer with a prostate-specific antigen (PSA) test. The decision is still unsettled despite the results of a giant, long-term study published earlier this month in the journal The Lancet. The study did not support the use of widespread screening.

“What makes the decision so tricky? It’s partly that prostate cancer is a weird cancer. Unlike cancer of the breast or the lung or the colon, which tends to kill people within five or 10 years, prostate cancer is usually slow growing. Men tend to die with it rather than of it. In fact, many live with it for 30 years or more and never even know they have it.

“That said, 3 percent of men do die of prostate cancer. So if we had an easy, safe treatment for prostate cancer, it would make sense to screen everyone and treat all the cancers we found. But the main treatments for prostate cancer carry a high risk of causing urinary incontinence and erectile dysfunction.”