Prostate Cancer Screening May Not Be As Effective As We'd Like To Believe
Posted Apr 04 2011 8:10am
The Times They Are a-Changin' - Bob Dylan
There once was a time when prostate cancer was most often diagnosed late in the course of the disease after the patient presented complaining of back pain w/absurdly elevated prostate specific antigen (PSA) levels. Then someone had the bright idea to screen for prostate cancer by checking PSA levels (in addition to digital rectal examinations) in asymptomatic men after arbitrarily deciding to call all levels >4ng/mL abnormal. However, we've never really proven that this early screening makes a difference in mortality. After all, if we cure a disease that isn't going to affect mortality, what good are we doing.
Sure, we always read about the men who die from or because of prostate cancer, such as Frank Zappa (52yo), Johnny Ramone (55yo), Jerry Orbach (69yo), Telly Savalas (70yo), Dennis Hopper (74yo), Earl Woods (74yo), and Pierre Elliott Trudeau (80yo). And we hear even more often from those who were successfully treated, such as Robert DeNiro (now 8 years post-diagnosis), Rudy Giuliani (10 years), Roger Moore (18 years), General H. Norman Schwarzkopf (18 years), Louis Farrakhan (20 years), and Senator Bob Dole (20 years). But have we helped them live any longer than if we'd just watched & waited? And at cost were these men "cured" with life changing side effects, eg incontinence, erectile dysfunction, proctitis & diarrhea.