Prostate cancer experts bash panel's PSA test recommendation

A man gets a PSA test to screen for prostate cancer.

/ CBS

(CBS/AP) Prostate cancer specialists are pushing back against an expert panel's recommendation that healthy men shouldn't get PSA blood tests for detecting prostate cancer.

"We all agree that we've got to do a better job of figuring out who would benefit from PSA screening," said Dr. Scott Eggener, a prostate cancer specialist at the University of Chicago. "But a blanket statement of just doing away with it altogether ... seems over-aggressive and irresponsible."

The U.S. Preventive Services Task Force had examined all the evidence and found little if any reduction in deaths from routine PSA screening, but it did conclude that too many men are diagnosed with tumors that never would have killed them and suffer serious side effects because of it.

Dr. Deepak Kapoor, chairman and chief executive of Integrated Medical Professionals, which includes the nation's largest urology practice, disagreed to the New York Times, saying "We will not allow patients to die, which is what will happen if this recommendation is accepted."

The idea that finding cancer early can be more harmful than helpful is a tough one to grasp - but it's at the heart of this debate.

According to the task force, high levels of PSA in the bloodstream - or prostate-specific antigen - only sometimes signals prostate cancer. But it can also indicate an infection or an enlarged prostate, or tiny tumors that may never pose a threat. There's no way to tell in advance who needs aggressive treatment.

In fact, most men who undergo a biopsy for an abnormal PSA test don't have prostate cancer. By one estimate screening detects small tumors that will prove too slow-growing to be deadly in two of every five men whose cancer is caught through a PSA test. Treatments, including radiation and surgery, often carry significant risks of side effects. These include incontinence, impotence, or other complications that can lead to death.

"If we had a test that could distinguish between a cancer that was going to be aggressive and a cancer that was not, that would be fabulous," task force chair Dr. Virginia Moyer of the Baylor College of Medicine, said.

That task force's recommendation isn't final - it's a draft open for public debate. Clearly the debate is already under way.

"The U.S. Preventive Services Task Force is a group of primary care physicians like pediatricians and OB/GYNs who never treat prostate cancer," Dr. Herbert Lepor, professor of urology at New York University School of Medicine, told Reuters. "They have simply misinterpreted the studies and have not seen men die of this fatal disease."

About 1 in 6 U.S. men will be diagnosed with prostate cancer at some point in their life. In the U.S., about 217,000 men are diagnosed with prostate cancer each year, and 32,000 die.

Men who experience prostate cancer symptoms or have already had prostate cancer are not affected by the new recommendation.

Dr. Michael Barry of Massachusetts General Hospital, who heads the Foundation for Informed Medical Decision-Making that helps patients make their own choices, had his take on all the hubbub: "The truth is that like so many things in medicine, there's no one-size-fits-all."

[Bookmn60]

We should put these so called "experts" on one of Obama's "death panels". In 2003 after a routine physical my PSA level had tripled from the previous year. My urologist confirmed Stage II cancer with a Gleason score of 6. This is about saving lives, not cutting costs. I wonder how old these "experts" are.
And you can be sure they probably will get PSA tests.

[Dr_David_Samadi]

The suggestion that PSA screening is self-serving for urologists and prostate cancer experts fails to take into account the goal of saving lives. Today, the PSA test saves lives. Of course our hope is that tomorrow, a better test will be developed and more lives will be saved. But, why abandon a useful tool until that time? The panel's recommendation is counter to the very foundation of medical advancement. http://www.youtube.com/watch?v=HYxPqdPdZIA

[leblanc666]

In 2009 at the age of 57 I had check up, 1st in 6 years. Had the digital examine, everything was fine, picture of health. Never had a PSA ran before. Then the PSA came back at 26.5. Rechecked 1 month later at 28.3. Got a biopsy, all 12 biopsies were positive at an 8 Gleason (10 is the highest). PSA then went to 33.9. All the doctors were betting it had metastisized outside the Prostate. I had done a lot of supplements and alternaitve things prior to deciding on the biopsy. But luckily, cancer was contained in the Prostate and was treated at MD Anderson with Proton therapy. I am now cured thanks to that PSA test.

Had I never got the PSA ran, no one would have ever known. Because the digital examine by my family doc never showed anything. Or at least they did not know what they were doing. The digital by the Docs at MD Anderson did detect it, but it was very slight and hard to detect. If I had never got the PSA ran, I would certainly had a serious metastisizing cancer issue that would have spread.

And thanks to these idiots saying a PSA is not effective, most insurance companies will probably no longer cover the cost, as they'll say it is not necessary. That is the trap the idiots are creating. And even if a PSA test detects one serious treatable cancer in 5000, it is worth it to save a life. Just remember, when the AMA or any governing body says the test is not worth it, then every insurance company will stop paying for it. I'm sure many people will eventually die unnecessarily and only to save a buck for the insurance companies.

[dkjack]

OF COURSE they bash the panel! These urologists and oncologists know that the panel's findings are bad for business. That's why there were none on the panel. For them it's not about patients but about business.

[smc021-2009]

This is another assine recommnedation from the Feds. Right now this is the only screen we have other than a physical DRE which is even worse as a diagnostic tool. Until we get something better we should stick with this. BTW a blood test for PSA is not making urologists rich and if you had a history of Prostate cancer in your family you would be going to see a urologist a least annually anyway that is if you have a brain which in your case I doubt.

[qmpash]

There is nothing wrong for a healthy man to get a PSA test. However, they should be made aware of just how inaccurate they are. Many men have false positives. Even worse, a PSA may indicate no cancer exists when there actually is one. By the time that it makes its presence known, it is often too late for effective treatment. In families where this type of cancer is prevalent, it should be combined with an x-ray, MRI or a biopsy to make certain.

[PoliticalCynic]

Does anyone think we would say "don't test" if this was something like say-a routine test for cancer in WOMEN?

Did anyone else noticed WHO chaired a panel on a health issue that ONLY impacts MEN?

Let's all think REALLY hard about what's REALLY going on here.