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To Screen or Not to Screen for Prostate Cancer

Posted Aug 04 2009 6:45pm

For the past 40 years doctors have emphasized the value of routine annual screening to avoid more advanced cancer. However some leading scientists have now vocally opposed routine screening for most cancers.

Among these scientists is world-famous Dr. Deepak Chopra. Ironically he is associated with "Care to Make a Difference" (www.Care2.com), whose senior editor yesterday reviewed why routine annual prostate cancer screening is so important.(See www.care2.com/greenliving/symptoms-of-six-common-cancers.html?e05458ea9260a1354f

As I pointed out to the editor in some comments at her website earlier this morning, she is right on-target. However, she needs to know that Dr. Chopra last month published an article which goes counter to her advocacy of screening. ("What's Worse: Health Care or Cancer?", The Chopra Center, July 29, 2009, www.chopra.com/wordsfromdeepak.)

Another screening opponent, with whom I spoke two weeks ago, is pre-eminent oncologist, Dr. Otis Brawling, the American Cancer Society's Chief Medical Officer. During my recent phone conversation with him and in his various publications, he too has disavowed the effectiveness of screening as a means for effectively preventing advanced prostate, lung, and most other cancers. (See Natasha Singer, New York Times, p. 1A, July 16, 2009, posted in www.nytimes.com/2009/07/17/health/17screening.html.)

Among Dr. Brawley's reasons for this surprising stance is that screening for most cancers has not been proven to reduce the number of deaths caused by such diseases.And he adds that PSA screening leads to excessive anxiety despite slow-growing cancers for the vast majority of patients. Worse yet, he argues, patients often go on to demand excessive, costly treatments like surgery, with after-effects like ED and incontinence that can be more onerous that the prostate cancer itself.

The well-meaning thoughts of greatly respected physicians and scientists should not dissuade anyone from promoting screening. Not only can screening save lives, but it will often prevent patients from having to experience excruciating pain in case they end up being among the substantial minoriy whose cancer metastasizes.

The odds may be in most patients' favor, but in view of scientists' inability to assess which cancer will be aggressive and which won't, why take a chance?

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