A conversation that all men should have with their doctor

John Fisher
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Stopping Medical Injustice
Around age 40, all men should have a conversation with their doctor about the risks and benefits of screening for prostate cancer.  Unfortunately, this conversation rarely occurs.  And it's a shame--this is a conversation that can save your life.  Prostate cancer is more treatable when caught early.

How a simple blood test can save your life  

First, the basics about screening for prostate cancer.  A simple blood test called the Prostate Specific Antigen ("PSA") test can detect prostate cancer in its earliest stages before the cancer causes any symptoms.  PSA is a substance produced by the prostate gland and the PSA level in a man's blood is an important marker of many prostate diseases, including cancer.  The three most common prostate diseases--prostatitis, benign prostatic hyperplasia (BPH) and prostate cancer--may cause elevated PSA levels in the blood.

PSA is a tumor marker that is used for the early detection of cancer and screening for PSA is responsible for a substantial shift towards detection of prostate cancer at earlier stages.  Higher values of PSA are associated with a higher risk of prostate cancer.  Screening with a PSA test and a digital rectal examination decrease the risk of being diagnosed with metastatic prostate cancer.

While most primary care physicians order the PSA test for their male patients beginning at age 40, it is unfortunate that few physicians discuss the risks and benefits of screening for prostate cancer with their patients.  Most major medical organizations, including the American Urological Association and the American Cancer Society, recommend that clinicians discuss the potential and known harms of PSA screening with their patients, consider their patients' preferences, and individualize screening decisions.  They agree that the most appropriate candidates for screening include men age 50 years or older who have a life expectancy of at least 10 years.

An important conversation you must have with your doctor
 
The American Urological Association believes that the decision to screen is one that a man should make with his doctor following a careful discussion of the benefits and risks of screening.  The risks of over-detection of prostate cancer and over-treatment should be included in that conversation.  According to the American Urological Association, "[t]he decision to use PSA for the early detection of prostate cancer should be individualized."  This means that each patient should made the choice about screening after a thorough discussion of the risks and benefits with his doctor.

It is a shame that many doctors do not explain the benefits of PSA testing to their male patients.  Regardless of the physician's beliefs about the value of screening for cancer, you should have the right to make your own decision.  Patient education about screening for prostate cancer is rarely done by physicians. It's unfortunate--this is a conversation that might save your life.         

How you can get more information about screening for prostate cancer 

If you want more information about screening for prostate cancer, I welcome your phone call on my toll-free cell at 1-866-889-6882.  You are always welcome to request a FREE copy of my book, The Seven Deadly Mistakes of Malpractice Victims, by sending an e-mail to me at [email protected]