Sunday, March 22, 2009
PSA Tests for Men
I wish I would have written the post that Dr. Bob Wachter did on the new evidence about Prostate Specific Antigen (PSA) tests for men. Two new rigorous studies have been published in the New England Journal that address the value of PSA screening.
I can tell you that every man I treat asks for these tests and I have been pretty unsuccessful in influencing anyone to forgo the test or "watch and wait" if their levels were elevated. Yet I have seen elderly men decline rapidly after receiving prostate surgery or radiation that they never needed. Wachter quotes a Dartmouth Endocrinologist:
… In the final analysis, most of these one million extra cases of prostate cancer [diagnosed through PSA screening] represent nothing more than pseudodisease: disease that would never progress enough to cause symptoms—or flat-out would never progress at all… I should be clear that none of this should be interpreted as saying that PSA testing will never work. In fact, while many men may have been hurt by the ensuing treatment, a few others may have been helped. And it is possible that the PSA test can be modified such that it finds much less cancer and therefore makes much more sense. But right now we need to be clearer about the primary effect of the way it has been used so far: it has been making men sick.
You owe it to yourself (and your father or husband) to head over to Wachter's World and read what he has to say.
Posted by Toni Brayer, MD at 6:38 AM