Prostate Protestation

I've spent the past three days writing a response to an article that appeared in the local paper.  I found the process of doing this challenging but very satisfying.  It stirs up memories of how much I enjoyed being a media agitator in Phoenix.  Maybe there's a lesson here about finding my post retirement path. Here's the letter.

March 5, 2012

Editor

Press & Sun-Bulletin

P.O. Box 1270

Binghamton, NY 13902-1270

On March 2nd The Press & Sun Bulletin ran an article by Jennifer Micale entitled "Drive urges screenings for prostate cancer - Libous helps promote awareness campaign." 

The article announced the launching of the "I Turned Pro: Proactive on Prostate Cancer" campaign by Lourdes Hospital, UHS and state Sen. Thomas W. Libous. 

Prostate cancer is a major men's health issue and the goal of this campaign "to raise awareness of the disease, its diagnosis and treatment" is important and should be applauded.  My concern is that the campaign is strongly encouraging men over 50 to be screened by having a prostate-specific antigen (PSA) blood test.

I am a 64 year old male who has decided to discontinue having PSA tests.  My investigation of this issue has convinced me that there is a growing consensus in the medical community that PSA tests are, in most cases, not a good idea.  Current research is showing that, according to a recent article in theNew York Times,  "regular PSA testing does not save lives and can lead  to aggressive treatments that leave men impotent, incontinent or both."

In October, 2011 the  U.S. PreventiveServices Task Force (USPSTF)  issued a draft report   which "recommends against prostate-specific antigen (PSA)-based screening for prostate cancer. This recommendation applies to men in the U.S. population that do not have symptoms that are highly suspicious for prostate cancer, regardless of age, race, or family history. "

The report states that,"The evidence is convincing that for men aged 70 years and older, screening has no mortality benefit. For men aged 50 to 69 years, the evidence is convincing that the reduction in prostate cancer mortality 10 years after screening is small to none."

The report goes on to document harms related to screening and harms related to treament of screen detected cancer. 

"Adequate evidence also shows that up to 5 in 1,000 men will die within 1 month of prostate cancer surgery and between 10 and 70 men will have serious complications but survive. Radiotherapy and surgery result in adverse effects, including urinary incontinence and erectile dysfunction in at least 200 to 300 of 1,000 men treated with these therapies. Radiotherapy is also associated with bowel dysfunction."

The awareness goals of the "I Turned Pro" campaign are honorable and important.  Its recommendation that men over 5O receive PSA screening should be revised to better reflect the current state of medical knowledge.

Ferd Haverly

1609 Buffalo Street

Endicott, New York 13760

ferd@haverly.org