Responding to continued debate over PSA screening, and today’s American Cancer Society statement, the Prostate Cancer Foundation (PCF) reiterated its position that PSA screening remains a valuable tool, in combination with other tools, for identifying potential prostate disease, including cancer. It is also calling for more reasoned discussion that empowers patients and their physicians and improves patients’ understanding of PSA data, prostate cancer and treatment options.
“Every man has the right to know if he has cancer and to make informed decisions with his urologist. This requires a thorough dialog between patients, family members and urologists that weighs the pros and cons of screening and treatment options”
“Every man has the right to know if he has cancer and to make informed decisions with his urologist. This requires a thorough dialog between patients, family members and urologists that weighs the pros and cons of screening and treatment options,” says Jonathan W. Simons, president and CEO of PCF. “While medical specialists know that the current PSA test is imperfect, it can be an important tool for diagnosing various problems with the prostate and taking care of men’s health.”
Last year more than 27,000 American men died of prostate cancer—one every 19 minutes—and more than 192,000 new cases were diagnosed. There is also good news. With advances in awareness, new treatments and earlier detection and treatment, the death rate for prostate cancer has dropped by 40 percent of what was once projected.
Controversy has risen over screening for the prostate-specific antigen (PSA) because it is not cancer-specific. Further, once cancer is diagnosed, it is still very difficult in some patients to differentiate between the indolent (slow-growing) and very aggressive, potentially lethal, varieties of prostate cancer. As a result, overtreatment of some patients does occur. PCF supports the guidelines laid out by the American Urological Association that call for a baseline PSA screening at 40 years old and then a follow up strategy developed by the physician and patient, based upon the patient’s specific health status and family history. (See AUA Guidelines below.) If cancer is found, risk factors including family and patient histories, a physical exam, Gleason scores, PSA velocity, and personal preferences should all be considered when developing an individualized treatment plan that is best suited for the patient.
“Unfortunately, public debate has focused mostly on the limitations of the PSA blood test rather than improving processes for informing patients. We should not throw this proverbial baby out with the bath water,” explains Simons. “PCF-funded researchers are making crucial progress in identifying new biomarkers that could one day make the PSA test obsolete. Until new diagnostics are available, we need to guard against telling patients not to be screened. Discussions of early detection of prostate cancers, when they are best treated, are imperative.”
The debate also underscores the unmet and urgent need for more research directed toward developing better, more prostate cancer-specific biomarkers and diagnostic tests. As the nation looks to reform healthcare, an important strategy for attaining real cost savings is increased investment in research so healthcare providers can cure patients earlier and over treat less. Prostate cancer, by incidence, is to men what breast cancer is to women, but federal funding of research for this disease is approximately 40 percent lower. With many American families burdened by both prostate and breast cancers, many prostate cancer organizations are working to increase investment and achieve the same crucial success in funding as the breast cancer community.
PCF experts have calculated that having the ability to distinguish between lethal and non-lethal or indolent varieties of prostate cancer might have saved an estimated $30 billion dollars between 1986 and 2005. With the tools to identify which patients had aggressive prostate cancer, overtreatment could have been avoided and more lives would have been saved by directing intensive care to those who needed it most.
Tomorrow, actor Louis Gossett, Jr. will testify about his recent prostate cancer diagnosis before the House Committee on Oversight and Government Reform. The hearing will explore prostate cancer screening, research and treatment matters. PCF-funded researcher, Theodore L. DeWeese, M.D., Professor of Radiation Oncology and Molecular Radiation Sciences, Urology and Oncology, Chairman and Radiation Oncologist-in-Chief of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Hospital, will also provide testimony. Otis Brawley from the American Cancer Society is also scheduled to testify.
Higher diet quality associated with reduced risk of prostate cancer grade reclassification