Should people get screened for prostate cancer

Transcript

Does prostate cancer screening save lives?

We simply don’t know at this point, there are clinical studies that suggest that it does, those studies have some problems, there are clinical studies that suggest it does not. We simply do not know if prostate cancer screening saves lives.  

What could be the problem with being screened?

The tests themselves are not harmful, the end results are.  We actually have in the United States a higher suicide rate amongst men who end up getting screened and start worrying about their PSA.  One of the harms we do know occurs is, a substantial number of men who are cured of prostate cancer, actually had a disease that, if left alone, never would have bothered them.

Do we know who needs to be treated?

About 50-60% of men who we treat we actually now believe don’t need to be treated. Unfortunately we don’t have a good test to say, Mr Jones ‘you have disease that needs to be treated’, Mr Smith ‘you have disease that needs to be watched’.

What about if you have an aggressive form of the disease?

You can have a disease that looks aggressive under the microscope, and I routinely recommend that those men get treated; however I don’t tell them that they definitely have to get treated.  I tell them I think it’s a good idea to be treated; as opposed to I know it’s a good idea to be treated.  

How should men come to a decision about treatment?

I recommend that men have a good conversation with at least one Urologist, at least one Radiation Oncologist, perhaps a Medical Oncologist who does not have a vested interest and come to a decision about treatment.

What would be your final comment?

Men need to know the potential risks, and realise that there are potential risks.  They need to realise that there are potential benefits, and the individual man needs to make a decision.  Literally no professional organisation today says that all men should be screened, they say men need to make a decision after understanding this problem.