Wednesday, April 10, 2013

To PSA or not to PSA

I don't have a definitive answer for you. But the American College of Physicians published a statement in the Annals of Internal Medicine recommending against screening men younger than 50 with the prostate-specific antigen test. Also screening men older than 69 with less than 10 to 15 years to live was discouraged.

But the patient and doctor must decide this, really.  Doctors must explain it to patients.

The problem with PSA is that it catches some cancers that would never have affected a man's life, yet the treatments definitely can cause incontinence or impotence.

Tough call.

The US Preventive Services Task Force has come out against testing of average-risk men.

The American Urological Association says case by case basis.

Better screening is needed. Most agree on that.

So what to do--at least ask the doctor about it. I see so many older people sitting in doctor's offices, looking at the floor, passive, calm--you know they will do what "doctor" says.

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