Common prostate cancer test seen as unreliable

There will be a lot of interest in cancer screening after Steve Jobs' death, and now there is a major change coming is in the the screening test for prostate cancer.

CBS News medical correspondent Dr. Jon LaPook reports that a key government panel is set to recommend that healthy men no longer receive the PSA, or prostate specific antigen, blood test.

Almost 241,000 cases of prostate cancer, and almost 34,000 resulting deaths are expected this year. Every year, thousands of Americans receive screening with a blood test called PSA in the hopes of detecting and treating prostate cancer early. But the test has come under fire in recent years, and next week a government task force is expected to make a startling announcement: men should not receive routine PSA screening.

The PSA blood test has become more and more controversial over the past decade because it is notoriously poor at identifying cancer. The problem is that PSA can rise from causes other than cancer, such as infections and an enlarged prostate. And even when cancer is found, it may be growing so slowly that it never would have caused a problem.

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For every 100 men, 16 will develop prostate cancer in their lifetime but only three will die from it.

Studies have shown you need to test a lot of men and do a lot of biopsies to save one life.

In one study, 1,410 men needed to get PSA screening to find 48 cancers and save one life over nine years.

Treatment of prostate cancer can cause serious side-effects, such as urinary incontinence and sexual dysfunction. A panel reviewing the major PSA studies for the U.S. Preventative Services Task Force concludes "PSA-based screening results in small or no reduction in prostate cancer-specific mortality."

The likely new recomendation will be that PSA screenings are not carried out routinely, but are still used for those with a family history of prostate cancer, as well as those in remission testing against its return.

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[erbgro]

Another poorly researched and reported article by the major media. Someone should investigate the 'distinguished' panel to see if they or their institutions receive government grants that they don't want cut off. Seems like as the govt. takes over medicine we will see more of this nonsense - saving money by declaring some people 'expendable'. BTW - there is NO 'false positive' in a PSA test. PSA is a measurement test, not a diagnostic test. And many so-called studies that are used are 7-10 years after treatment. This is a meaningless (much too short) time frame to judge whether treatment is successful. Since when is ignorance preferable to knowledge? And many of the 'bad' results from treatment stems from urologic surgeons who should not be performing prostate cancer surgery - or radiologists who use a different criteria for 'cure' than surgeons. I had a rising PSA, a positive biopsy and surgery (at Hopkins) 11 years ago. And still a not measureable PSA. No sleepless nights; no watching my PSA rise. No knowing that if something else doesn't kill me first, prostate cancer will. Don't be stupid guys. Get tested and proceed with knowledge, not ignorance.

[trixie1961]

My 50 yr old husband was diagnosed with prostate cancer earlier this year. He had his first PSA drawn during a physical and it was 14...biopsy performed showed cancer with gleason score of 7. He had surgery done robotically in June and post surgical pathology showed it had spread outside the prostate to seminal vesicles and made it to one lymph node. Right now his PSA score is at the lowest measurement possible and we have opted to not proceed with radiation unless his PSA begins to rise. Thank God for the PSA test or this would not have been caught until it was even more advanced. I believe baseline should be drawn at 45 and definitely not do away with routine test every year after 50. My husband had no family history.

[WalterAdkins]

People should never forget that real health depends how well you take care of yourself and not what health insurance you carry but I agree health insurance is important for every one. Search "************" or online for dollar a day insurance plans.

[grannamawmaw]

I truly cannot believe you are reporting this! Come on, how many lives have been saved by a simple PSA test? My husband is one. He was recently diagnosed with prostate cancer at the age of 52. If it were not for the fact that he had a previous PSA for a baseline, he would have very soon ended up with cancer spreading! His points had spiked enough in 2 years to be a red flag to his doctor. Even though his number was in the "normal" level, he had almost the whole prostate full of a fairly quick spreading cancer. (The new "normal" has been lowered.) It is not fair to report this insufficient information to the public when someone might actually believe what you are reporting and not think he need to be tested! You could cause him his life! By the way, there is no history of prostate cancer in my husbands family. PLEASE follow through on this story with more accurate information to help those that are unfamiliar with the PSA to understand why they should be regularly checked. You could save some lives. Thank You!

[davesutn]

I suspect that Scott Pelley and Jon La Pook have not had prostate concer. I have and so have at least 8 people I know of. I don't think any of these would have been detected without a PSA test. I'm getting really tired of hearing these recommendations. Does the woman who headed the taskforce feel the same way about breast cancer?

[chipndale610]

This article is ********. If you have a fairly good doctor and if you're smart enough to do some study on your own, a PSA exam once a year will keep you out of trouble. A digital exam and a PSA test every year will give you a base line to work with. When the tests are drastically different than your base line information then you go for a biopsy. The biopsy will tell you if you have cancer or if you need to adjust your base line and keep going with your annual testing. This is what I did and six years ago we found prostate cancer using this process. I had a radical prostatectomy and I will probably live another 50 years.

I agree that information from the PSA taken by itself or Information from a digital exam taken by itself might be confusing. But look at both and you can make some intelligent decisions regarding your individual situation.

[cindylou0416]

My dad died almost a year ago from Prostate Cancer, a highly curable disease, if caught early, for most men. My dad had PSA tests that proved invaluable in detecting he had cancer. It was his general physician's negligence in administering a prostate exam in the first place that was the problem. My dad had told his physician that he thought there was something wrong with him for 6 years. By the time his doctor finally believed him and did an exam, he had stage 4 prostate cancer. It has spread to his bones and lymph system. The PSA tests he had after that showed the progression of his cancer and how rapidly it was spreading. I think the tests are helpful and useful, 100% accurate or not!

[desertsage1]

Mr Pelley: or is it Mr Rather Pelley: Shame on you for this drivel.

"Studies have shown you need to test a lot of men and do a lot of biopsies to save one life."

Would it change your ill informed, one sided, insensitive reporting style if it was your life....or you dad's?

Maybe you could repeat the story, add more facts (start with the Prostate Cancer curing success story from places like Loma Linda U Med Center) and tack on the following:

The Starfish Story

A young girl was walking along a beach upon which thousands of starfish had been washed up during a terrible storm. When she came to each starfish, she would pick it up, and throw it back into the ocean. People watched her with amusement.

She had been doing this for some time when a man approached her and said, "Little girl, why are you doing this? Look at this beach! You can't save all these starfish. You can't begin to make a difference!"

The girl seemed crushed, suddenly deflated. But after a few moments, she bent down, picked up another starfish, and hurled it as far as she could into the ocean. Then she looked up at the man and replied,

"Well, I made a difference to that one!"

[bobnjersey]

[next week a government task force is expected to make a startling announcement: men should not receive routine PSA screening. ]
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we just need terrorists to start using 'penil-bombs' ... and then every man can get a 'scan' at the airport for early detection.

amazing how much money will be spent to mitigate a 1 in 35 million chance of someething happening ... a terrorist incident on a plane ... and everyone cries and moans about any money being spent to solve the biggest killers of american citizens (500k/yr for cancer; 500k/yr for heart disease).

[desertsage1]

CBS I am disappointed. Not surprised anymore by Rather schlocky CBS reporting style, but disappointed that you have not cleaned up your act and made an effort to report more accurately...or at least both sides of a story so that readers can draw an informed conclusion. For me, PSA testing did indeed suggest the need for a biopsy that did indeed reveal prostate cancer. I won't bore the readers with all the numbers, test scores etc. But I will say that proton therapy cured the cancer. I am one of thousands and thousands of men (do a little research on proton beam work at Loma Linda U Med Center) who dodged the proton cancer bullet with zero side affects and continue to live a healthy, wonderful, unlimited lifestyle.

Shame on you for suggesting it is not important to save only one life......It would be VERY important to your male CBS staffers ifit was there life, or a life in their family or circle of friends. Shame on you.