Prostate Cancer Screening – Why It is Very Much an Important Procedure
Prostate cancer screening especially testing for the PSA level in the blood has been enshrouded with lots of controversies in recent times.
The most heated is declaration of the United States Preventive Services Task Force (USPSTF) that the test could cause more harm than good for men because it may lead to unnecessary invasive treatments with consequential side effects in the long run.
Dr. John L. Pfenninger, a columnist with the Midland Daily News posted an article in his column that reemphasized the importance of prostate cancer screening. Here are more details from the online post:
Prostate cancer kills nearly 30,000 men in the United States every year, out of the 240,000 cases that occur. In non-smokers, it is the No. 1 cause of cancer deaths. Men in the U.S. have a 1 in 6 lifetime risk of developing prostate cancer.
It is comparable to 40,000 deaths from breast cancer in women (230,000 cases). For non-smokers, the next most common cause of cancer death is colon and rectal cancer, accounting for about 150,000 deaths per year in men and women combined.
It would seem reasonable to screen for early detection of prostate cancer, if at all possible. A test has been developed looking at the levels of prostatic specific antigen (PSA) in the bloodstream. Elevated levels can indicate a cancer. PSA is secreted by the prostate gland which lies just below the bladder.
The prostate can be felt on a digital exam through the rectum. Physicians can usually detect whether or not the gland is enlarged or irregular. PSA is normally secreted in semen and allows the sperm to swim more freely. It also dissolves the cervical mucous to allow the sperm to enter the uterus.
All men will have PSA in their bloodstream, too. Levels increase with age. Normal levels from age 50 to 59 are 0.3 to 4.7 ng/ml, from 60 to 69 are 0.3 to 8.3 ng/ml, and over 70, from 0.4 to 17.8 ng/ml. These numbers indicate that there is a very large variation among individuals.
In general, a test result of over 4 is suspicious for prostate cancer. Many other factors must be taken into account, besides a man’s age. Other things that can raise the PSA level, in addition to age and cancer, include having a large prostate (PBH or benign prostatic hypertrophy). Most men will experience this as they age. Having any inflammation or infection will also do it. A recent ejaculation or digital exam can cause the PSA to elevate. Conceivably, even a forced, hard bowel movement could elevate the PSA. Men should consider these things if they are having their blood drawn for a screen.
The United States Preventive Services Task Force (USPSTF) concluded in 2012 that screening for prostate cancer causes more harm than good. They claim it leads to over-diagnosis and over-treatment because “most prostatic cancer is asymptomatic for life” and “treatment involves significant risks and complications”. “Expected benefits do not outweigh the harms from screening.”
They claim that the results in the reduction of prostate cancer morbidity are small or non-existent. They estimate that only 1 per 1,000 screened avoid death, while 4 to 5 per 1,000 screened will still die of prostate cancer. They point out that treatment often results in erectile dysfunction and urinary incontinence. Men also experience cardiovascular events during the surgery, blood clots to the lung, and operative deaths. Click here to read the full article.
Conclusively, from the above piece, the point has been made that though the PSA test may not be the best, it yet is very crucial in monitoring the possibility of prostate cancer in the body.
Despite the controversies, many doctors and patients have discovered that this treatment readily helps to save the lives of many people.
The lives of many men have been saved by this test. So, I personally still think that this test is very much an important in helping to provide relieve to those diagnosed with this type of cancer disease.
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