There has been a lively debate in the medical community on the role of the PSA test in the diagnosis and treatment of prostate cancer. This debate must not lead more men to ignore the warning signs of prostate cancer – more men were diagnosed with prostate cancer than Americans were diagnosed with breast cancer last year.
When confronted by a doctor out of concern for a possible diagnosis of prostate cancer, men, and their families, instinctually believe action must be taken immediately. An honest observer would see there are far too many biopsies in the detection of prostate cancer today. More than 1 million mindless – and painful — biopsies are performed every year.
The truth is most men more than 50 years-old have cancer cells in their prostate. A traditional biopsy will only be positive 20% of the time and most men diagnosed with prostate cancer will die of something other than prostate cancer.
This overreaction on misinformation leads to unnecessary patient anxiety, serious infection, bleeding and temporary impotence, in addition to the economic burden of unnecessary treatment shared by patients, their families and society. These are hardly trivial side effects.
However, it cannot be lost that nearly just as many men (33,720 in 2011) die of prostate cancer as women die of breast cancer. Just because our detection methods remain imperfect is not an excuse for men to ignore their risk factors. The “bad” forms of prostate cancer need to be detected and aggressively treated.
So what should patients, their families and medical providers do?
The answer is to take a page from women in their fight against breast cancer and fight back to secure as much information as possible. Ignorance cannot be an excuse. Claiming the science isn’t settled cannot be an excuse.
Men need to understand their risk factors; PSA results can still be used as a guideline to evaluate one’s risk of having “bad” prostate cancer. However, instead of rushing into a biopsy, patients, and medical providers, should explore viable alternatives to gain clarity about the health of one’s prostate. Recent imaging advancements, such as modern multi-parametric MRI, have been shown to dramatically improve diagnosis accuracy rates.
Breast cancer has rightly become a central focus in the media and in conversations between friends and family members. Far too many Americans die of breast cancer. More women need to be aware of their risk factors and treatment options. However, let’s not forget that prostate cancer also changes the lives of too many men.