The Merck Manuals issued the following announcement on Sep. 24.
Few preventative tests are as debated and controversial as prostate cancer screenings. Recommendations for the test vary among professional groups such as the The National Comprehensive Cancer Network, the American Urological Association, and the American Cancer Society, leaving men and their families to navigate conflicting and confusing information about when – and if – they should be screened.
In a recent editorial, Leonard Gomella, MD, The Bernard W. Godwin Professor of Prostate Cancer and Chairman, Department of Urology, Sidney Kimmel Cancer Center at Thomas Jefferson University, shared some key facts men should take into account when considering a prostate cancer screening and discussing the test with their doctor.
1. Prostate Screenings Have Changed in the Last Several Decades
The first thing to understand about prostate screenings is that they are different than they were a generation ago. In the past, screenings involved a rectal exam to physically examine the prostate and determine if a biopsy was warranted. Today, and for the last several decades, physicians have increasingly relied on a blood test to measure a substance made by your prostate called PSA.
2. There are Pros and Cons to Prostate Cancer Screenings
The greatest benefit to screening is detecting aggressive forms of prostate cancer early. At the same time, the screening itself and potential biopsy presents some risks, including bleeding and infection. What's more, prostate cancers tend to grow relatively slowly, and there is a concern that the side effects of treatment, which can include erectile dysfunction or urinary incontinence may be more damaging than leaving the cancer untreated.
3. Prostate Cancer Doesn't Always Require Surgery or Radiation Therapy
Even when prostate cancer is detected, physicians today often recommend active surveillance (formerly called watchful waiting), meaning doctors give no treatment unless the cancer is progressing or changing. This can be a stressful situation for men to find themselves in, but it's important to understand the true risks and talk to a doctor about the best way to proceed with treatment.
4. Screening Recommendations Vary Significantly
Specific recommendations vary by group, but screening is considered in all men with a life expectancy of at least 10 to 15 years who are also older than 50 and in some who are younger who have risk factors, such as being African American or having a family history of prostate cancer or breast cancer. Benefits of screening may decrease with age.
5. Men Should Make the Decision for Themselves – with Input from a Doctor
Given the complications and controversies surrounding prostate cancer screening, virtually all organizations agree that no one should be screened without first having an in-depth conversation with their doctor to discuss the uncertainties, risks, and benefits.
Read more about prostate cancer screening considerations in Dr. Gomella's editorial on MerckManuals.com
About The Merck Manuals and MSD Manuals
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Original source can be found here.
