Discuss Prostate Screening With Your Doctor, Experts Now Say

Excerpt:

“Older men should talk to their doctors about the pros and cons of prostate cancer screening and make an individual decision that is right for them, an influential national panel of experts has proposed.

“The new recommendation, based on new data from a European trial as well as changes in the way men with prostate cancer are treated, modifies an earlier panel guideline from 2012 that advised men to skip prostate cancer screenings altogether. Screening is typically done using a blood test that measures levels of a protein released by the prostate gland called prostate-specific antigen, or PSA, which may indicate the presence of prostate cancer when elevated. But increased levels can also be caused by less serious medical conditions, like inflammation.”

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Precision-Medicine Approach Could Revive Prostate Cancer Test

Excerpt:

“A new study led by researchers at UC San Francisco and Kaiser Permanente has identified genetic predictors of normal prostate-specific antigen (PSA) levels in healthy men, which could be used to improve the accuracy of PSA-based prostate cancer screening tests.

“Until recently, PSA tests for prostate cancer were considered an exemplar of successful early cancer detection leading to improved treatment outcomes. But over the past five years, a series of studies has suggested that the tests are not sensitive enough: frequent false positives lead to too many unnecessary medical procedures, and false negatives give men a false sense of security. In 2012, the was given a ‘D’ rating by the U.S. Preventive Task Force, and the test is no longer covered by some insurers.”

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The Downside of Breast Cancer Screening

Excerpt:

“A 17-year study has concluded that screening mammography — in which all women in certain age groups are routinely screened for breast cancer — does not reduce the incidence of advanced tumors, but does increase the diagnosis of lesions that would never have led to health problems.

“In Denmark, screening was implemented in different regions at different times, so researchers there were able to compare groups of women who were screened with those who were not.”

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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.”

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Metastatic Prostate Cancer Cases Surge, Adding to Screening Controversy

Excerpt:

“A new study documents a decade-long increase in the number of men who have incurable prostate cancer at their initial diagnosis, an ominous finding that prostate cancer-screening proponents have been predicting.

“Both screening and diagnosis of early-stage prostate cancer have declined, coinciding with recommendations from an influential government advisory panel. In 2008, the U.S. Preventive Services Task Force said not to do routine PSA blood testing of men over age 74. And in 2012, it said to not screen any men – not even those at high risk – because the harms of unnecessary treatment outweigh the benefits of catching cancer early.”

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A Better Prostate-Cancer Test?

Excerpt:

“When Al Piazza learned he had prostate cancer, his first thought was, ‘Let’s get this out and be done with it,’ he says. But his urologist, Jeremy Lieb, said the side effects of treatment could be more harmful than the cancer itself.

“Dr. Lieb ran a genetic test on the patient’s biopsy sample, which calculated that Mr. Piazza, then 70 years old, had only a 3% chance of dying from prostate cancer over the next 10 years if he left the tumor untreated.

“Four years later, the retired AT&T manager from Discovery Bay, Calif., has been monitoring his cancer with regular blood tests and imaging scans and says he is comfortable leaving it alone. ‘My feeling is—it’s there, but it’s not going to kill me,’ Mr. Piazza says.”

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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.”

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MRI-Ultrasound Fusion Improves Prostate Biopsy Cancer Detection

“Magnetic resonance imaging-ultrasound fusion targeted prostate biopsy (MRF-TB) improves detection and risk stratification of high-grade disease and limits detection of clinically insignificant prostate cancer, according to a study published in the December issue of the The Journal of Urology.

“Neil Mendhiratta, from the New York University Langone Medical Center in New York City, and colleagues reported clinical outcomes for 452 consecutive men presenting for primary . Participants underwent prebiopsy multiparametric magnetic resonance imaging followed by MRF-TB and systematic biopsy.”


New Test for Prostate Cancer Significantly Improves Prostate Cancer Screening

“A study from Karolinska Institutet in Sweden shows that a new test for prostate cancer is better at detecting aggressive cancer than PSA. The new test, which has undergone trial in 58,818 men, discovers aggressive cancer earlier and reduces the number of false positive tests and unnecessary biopsies. The results are published in the scientific journal The Lancet Oncology.

“Prostate cancer is the second most common cancer among men worldwide, with over 1.2 million diagnosed in 2012. In number of men diagnosed with prostate cancer increases and within 20 years over 2 million men are estimated to be diagnosed yearly. Currently, PSA is used to diagnose prostate cancer, but the procedure has long been controversial.”