Wednesday, March 3, 2010

Are they trying to confuse us? They've succeeded

After years of recommending that all men get regular PSA tests and digital rectal exams, the American Cancer Society is revising its guidelines.

Now it's saying that men should discuss the benefits and risks of prostate cancer screening with their doctors.

It sounds like one of those risks of screening for prostate cancer is a positive test. That would then require some type of action, like surgery or radiation therapy.

The problem is that both of these solutions carry lots of side effects, but doctors can't be sure whether it's a fast or slow-growing tumor. If it's a slow growing tumor, then the cure might be worse than the disease.

The ACS now recommends:

"...that men with no symptoms of prostate cancer who are in relatively good health and can expect to live at least 10 more years have the opportunity to make an informed decision with their doctor about screening after learning about the uncertainties, risks, and potential benefits associated with prostate cancer screening. These talks should start at age 50. Men with no symptoms who are not expected to live more than 10 years (because of age or poor health) should not be offered prostate cancer screening. For them, the risks likely outweigh the benefits, researchers have concluded.

"As in earlier guidelines, ACS recommends men at high risk – African-American men and men who have a father, brother, or son diagnosed with prostate cancer before age 65 – begin those conversations earlier, at age 45. Men at higher risk – those with multiple family members affected by the disease before age 65 – should start even earlier, at age 40."

I'm almost glad that I'm past this phase. It makes me uneasy when my doctor doesn't really have a good answer.