February 15th, 2011
08:11 PM ET

Annual prostate cancer testing not necessary for some

Less may be more when it comes to prostate cancer screening, says a new study released this week at the Genitourinary Cancers Symposium in Orlando, Florida.

A study by Dutch researchers found that men whose first prostate-selective antigen or PSA blood test came back under 3.0 may not need annual testing; and those with levels under 2.0 can most likely go eight years before getting retested.

"The rate of cancer is very low in men with PSAs less than 3," said Dr. Nicholas Vogelzang, a spokesman for the American Society of Clinical Oncology, and moderator of the conference.

The study went on to say that men with PSA levels of 3 or higher should have prostate biopsies - a more aggressive standard than current recommendations, which suggest a biopsy in men with PSA levels over 4.

If and when to test men's PSA levels has been the subject of controversy in recent years. Many leading experts say testing, without knowing whether slightly elevated PSA levels will ever lead to cancer, can cause unnecessary anxiety for men.

A second study released at the same conference addressed treatments for men who fell into the "watchful waiting" category of of treatment for prostate cancer - a group of men who have some cancer cells in their prostates, but for whom the treatment may be more damaging than the disease itself; and who may die of other causes long before prostate cancer would kill them.

"This is an important paper because of this increasing anxiety that men feel as they are under 'watchful waiting,'" Vogelzang said.

According to the study, men who may be anxious about simply "keeping an eye on things," may benefit from taking the drug dutasteride (Avodart), which is currently used for non-cancerous prostate enlargement.

"With dutasteride, the PSA levels drop by about 50% or so," he said. "It seems to make the gland smaller, causes men to have less urinary symptoms, and may even reduce the amount of cancer in the gland."

A final study released Tuesday suggests that for men who opt to have robot-assisted prostate surgery, choosing a surgeon that has done more operations could provide the highest chances of success. Researchers found that surgeons had to perform more than 1,600 procedures before they were considered experts and had the skills to remove all evidence of cancer in most cases.

"The argument to be made is that it may be more sensible to use robots in a few centers of excellence," Vogelzang said, "rather than small hospitals buying them, and naive surgeons being asked to use them."

The researchers also encouraged doctors who want gain proficiency in the procedure to train at these large centers of excellence.

soundoff (33 Responses)
  1. BRBSanDiego

    Forwarding this to my finger happy doctor. Don't these guys read anything but the sports section.

    February 15, 2011 at 22:41 | Report abuse | Reply
  2. Jasper Cottrell

    "Many leading experts say testing, without knowing weather slightly elevated PSA levels will ever lead to cancer, can cause unnecessary anxiety for men."

    WEATHER?? WEATHER?!?! What kind of idiot writes this stuff? Could the writer POSSIBLY have meant WHETHER?

    Not to mention the fact that there are no units attached to the 3.0 or 4.0 numbers quoted. How about 3.0 nanograms per milliliter (abbreviated as ng/ml on most lab reports)? Oh no, oh my God, SCIENCE!!! Can't have any of that going on here....

    Come on, CNN. You want to act like you are a source of real, reliable information. Find a writer and an editor who speak and write standard English, and who can properly relay and interpret scientific and medical information. Otherwise, go report on Lady Gaga–which in fact seems to be your strong suit.

    February 15, 2011 at 22:48 | Report abuse | Reply
    • tracy

      you really spent that much time on a spelling error? get a life...

      February 16, 2011 at 00:47 | Report abuse |
    • Bill

      You definitely need to need to get a life.

      February 16, 2011 at 07:16 | Report abuse |
    • Jane Hackie

      yeah get a life!

      February 16, 2011 at 11:18 | Report abuse |
    • Lenny

      dude, please....get...a...life, you sound like class A loser.

      February 16, 2011 at 11:21 | Report abuse |
  3. Wheres the Source

    What is the source of the new study near the end of the article??

    "A final study released Tuesday suggests that for men who opt to have robot-assisted prostate surgery, choosing a surgeon that has done more operations could provide the highest chances of success. Researchers found that surgeons had to perform more than 1,600 procedures before they were considered experts and had the skills to remove all evidence of cancer in most cases."

    I would like to find that study, but he did not cite the source.

    February 16, 2011 at 01:22 | Report abuse | Reply
  4. dale4

    Spelling is not the problem. Its whether or not that men know the ability to detect the cancer and treatment (prevention), arly and seek help. I welcome any scientic discovery inany field that will benifit our society. And how about all of the buget cuts. We need help?

    February 16, 2011 at 02:07 | Report abuse | Reply
    • Meh

      your ADD is kicking in

      February 16, 2011 at 09:00 | Report abuse |
  5. leo

    why is it when it comes to MEN"S health/healthcare less is always best? BUT Women on the other hand should have every test/every year. I love when doctors say that alot of men should just live with prostate cancer because they will probably die of a health attach or somethingelse. if you said that to a woman about breast cancer, the whole world would come to an end
    When was the last time there was a national campaign for men's health..say even telling guys to get a physical or have their testicles check out on a regular basis for cancer
    It's women and their healthcare that is driving up prices. If men went to the doctor they same amount as women did the insurance companies would be out of business..

    February 16, 2011 at 06:03 | Report abuse | Reply
    • Meh

      Ive never heard of someone dying from a health attach before. Just get the darn test every year so you dont have to be surprised when you finally get it checked and discover something you cant handle.

      February 16, 2011 at 08:55 | Report abuse |
    • Dennis

      “Many leading experts say testing, without knowing whether slightly elevated PSA levels will ever lead to cancer, can cause unnecessary anxiety for men”. Can you imagine the reaction if the medical community suggested women forgo cancer screening because “We don’t want them to worry their pretty heads”?

      Do you remember the hue and cry last year when government guideline recommendations for breast cancer screening stated that for several groups of women annual mammograms were no longer necessary and every other year would protect just as well? The outcry from women was intense and immediate saying “The costs of annual screening were worth it even if just one life was saved”. The political pressure eventually caused the government to revise the guidelines.

      Until men find their voice their healthcare will continue to be marginalized.

      February 16, 2011 at 13:49 | Report abuse |
  6. Bill

    The article states that a surgeon should have done 1600 surgeries in order to be considered an expert. If every man followed this rule there would not no surgeons to do the procedure.

    February 16, 2011 at 07:22 | Report abuse | Reply
  7. Jason

    This is crazy, the reporting DR's comment of prostate cancer growing so slowly that you more than likely won't need to treat it, is insaine!! Yes the cancer may grow slowly in the prostate but it will quickly spread from the prostate to surrounding areas. That is what the Doctor told my grandfather, "you will die from something other than prostate cancer because it is a slow cancer". WRONG!!! It spread to his pelvic bones and my Grandfather died a very painful death. My father was then diagnosed and he had the radical prosectamy. Yes there are issues of impatence and contenance issues that occure with the surgery but at least you are alive.

    Please everyone keep in mind that this is research from only 1 study!!!

    February 16, 2011 at 08:07 | Report abuse | Reply
  8. Frank Ferry

    I watched with amazement the prostate report at 7:58am this morning. I had a psa test one yr ago this past Oct, it was 1.9 The next psa test one yr later was 4.0 Yes I have cancer, gleason 7. I'm 65 yrs old. I have since had a robotic prostatectomy. Cancer gone.
    I'm a good case for annual psa checks.

    February 16, 2011 at 08:12 | Report abuse | Reply
    • Don T.

      Good for you, Frank! I agree with you 1000%! I am a 5 year Gleason 9 PCa survivor ONLY because of the PSA test...I took aggressive action, had the puppy removed, caught it early and can now talk about it...The "go slow" opinions being expressed today will kill people...I'm all for early detection, informed evaluation, and aggressive action with guidance from a knowledgeable urologist.

      February 16, 2011 at 14:36 | Report abuse |
  9. Meh

    To say you dont need to get it done is foolish advice. If you are over 30, you should get the PSA blood work done every year. The writer should be ASHAMED to even propose this information. CNN is in serious FAIL MODE this morning.
    If you cry because you have to get a blood test, read up on what happens if you have prostate cancer and the procedures to get rid of it. Suck it up guys.

    February 16, 2011 at 08:52 | Report abuse | Reply
  10. RoyZ

    This article is rubbish, it has no links to the sources. Even if it did, there must be a flaw. There are many of us that watched our PSA go from 1.0 to 2.0 to 3.0 in 3 years who had cancer, so its a velocity of change measure that may indicate further testing. You can't test every 8 years. I do agree with a surgeon being more experienced in almost any case, as I did have a better outcome than my friends who used a less experienced surgeon with robotics.

    February 16, 2011 at 09:13 | Report abuse | Reply
  11. Dan

    I had prostate cancer with a PSA reading of 2.1 so this article is not necessarily accurate ! If your individual PSA reading goes up more than 20% a year ( which is the everage most urologists go by) than an alarm bell should go off . I had prostate surgery to remove my prostate and because it was caught early my chances of curability are much greater based on my final pathology results. To all men be diligent and prudent ! It is not easy to have the biosopy and surgery but the end result could certaintly offer you a much higher quality of life !!

    February 16, 2011 at 09:38 | Report abuse | Reply
  12. charles s

    There is a new test that does not use PSA scores: see http://www.cancer.med.umich.edu/news/prostate_psa08.shtml
    Lets scrap the PSA test because it produces so many false-positives.

    February 16, 2011 at 11:01 | Report abuse | Reply
  13. Mike

    I had prostate cancer with a PSA reading of 1.1 and ended up with nine out of twenty slices were cancer infected. Also the cancer had reached outside of the prostate but only very slightly. So the moral of the story is that even with a PSA reading of 1.1 get checked. I did have my prostate removed by robotics and it worked out better then without robotics. Remember this with robotics the surgeon can work easier, better because of the small tools he works with and can see ten times better because everything is magnified by ten. A regular surgeon can not beat those tools and it is a hard location to reach.

    February 16, 2011 at 11:16 | Report abuse | Reply
  14. Cynthia

    my husbands PSA was always in the 1 or 2 range, then raise to 3, rechecked in 6 months, raised to 4.25, had biopsy which I was first hesitant about, Gleason score of 8, cancer in all but one or 2 cores, cancer had already spread to bones – we needed to know even before this he had cancer, what we need is better testing – he now have a pronosis of 1 1/2 – 2 years, he is now only 59- if we had waited until sympotms has presented, we would have even less time together to fight this. It does not hurt go get PSA test, so why not?

    February 16, 2011 at 12:22 | Report abuse | Reply
  15. Victoria

    My husband had a psa of 5.?? last year and he had a very invasive test and all the results came back negative for cancer. He went again in Dec and it was 3.1, we have canceled all appointments for this year. He has a prostate that is a bit large and is 50, we have a good baseline for further tests, but they would have him in every 3 months. That kind of constant care just seems silly, and this is what the article is relating to. Sure the ones who do have cancer have a different opinion, but for every 60 prostates that are taken out only 1 will be the cause of death in a lifetime. Check the research into men with HPV infections, I think 18 and 16 are the ones identified as causing aggressive cancer in the prostate (saw on Dr. Oz a few months back). These are the same strains that cause cervical cancer in women. I am positive I do not have this and neither does my husband so this gives us some guideline that it might just be because his prostate is a bit large and the psa test is so unreliable. The link about the urine test is very interesting stated in an earlier post.

    February 16, 2011 at 13:25 | Report abuse | Reply
  16. Andy

    Was only 47 when diagnosed with early stage prostate cancer. Fortunately, I had a family doctor who proscribed a PSA test every year after I turned 40. The Dr. tracked my results every year. When my PSA shot up 1.2 points over the course of 1 year, I was scheduled for further tests with an urologist. He confirmed thru further testing that I indeed had cancer. I STRONGLY advise men to get tested. One question I did ask the urologist was "how long do you think I had this cancer?" His response was that it had been there growing about 6 years & was now manifesting itself. I asked if I didn't get treated how long I would have & he said I would probably be dead around age 55. I did get treated with Proton therapy & LOVED it. I opted to not do surgery. I'm now 15 months out of treatment & feel great! GET TESTED NOW!!! Your family deserves no less.

    BTW – my family doctor is a female. I thanked her for saving my life. She told me she submits EVERY male patient over the age of 40 for a PSA to track their numbers & has detected early prostate cancer in 16 of her male patients. How many of those guys do you think complained about a needle stick? Not me for sure! PSA at time of treatment – 3.8 now 2.1 & going down.

    February 16, 2011 at 13:43 | Report abuse | Reply
  17. Dan

    There" never" ever "is an unnecessary test for cancer of any kind--It has given me a greater chance of curability that I could never have had without ongoing PSA tests on my prostate !!!!!! Anyone who thinks that testing is not needed-think again. I was tested beginning at age 50 and diagnosed with my prostate cancer at age 60!! This ongoing testing caught the cancer way early because I had a doctor diligent enough to track and monitor my readings and recommend the biosopy at a reading of 2.1. Thank god for my doctor( and all those like him) who stayed on course , caught the cancer and eventually removed it through surgery !!

    February 16, 2011 at 14:43 | Report abuse | Reply
  18. Victoria

    Dan read the article again, it might give you some better insight to the findings in this study. No one is saying not to ever get tested, there are also better tests on the horizon for the ones that have been treated so aggressively and have done more harm than good. This information has nothing to do with your experience.

    February 16, 2011 at 15:02 | Report abuse | Reply
    • Dan

      Read it again lady and all the other comments to boot ! You are wrong in what you are implying and it looks like alot of other people who have gone through this agree with me !! Facts are facts !!!!

      February 16, 2011 at 15:26 | Report abuse |
    • Barryng

      Victoria, it is not your place, or any physicians for that matter, to make the statement, "It will do more harm than good.". When it comes to PSA testing and responding to acknowedgibly possibly false positive results, a cost/risk/benefit analysis is required. The physician should certainly offer his opinions, but it is absolutely the patients judgement that determines the action taken from the cost/risk/benefit analysis. From my perspective, the cost, risk, and minor discomfort of an unnecessary prostate biopsy is a very small price to pay considering the potential consequences (very premature death) for doing nothing. I will allow no one to make this kind of decision for me, especially someone who has nothing to lose as a result of the decision.

      February 17, 2011 at 06:22 | Report abuse |
  19. Michelle

    This report (not NEWS at all) really alarmed me.
    My husbands PSA went from under 3 to over 4 in a year. He had a biopsy 2 years ago which came back negative. This past November he had a second biopsy which came back positive with a Gleason score of 4 +3 = 7 so an aggressive form of cancer. NOT AT ALL SLOW GROWING! He underwent the robotic surgery a month ago. Cancer gone. If we had left it, being the aggressive form it would have spread to other vital organs.
    Why on earth would CNN ever publish such an unfounded report – GET TESTED MEN, each year....if you don't and leave it, it may be too late. The PSA is just an indicator, the biopsy is what reveals the cancer growth.
    My husband is 51 – no other health issues and in great shape – even better now as cancer free!

    February 16, 2011 at 15:07 | Report abuse | Reply
  20. Michelle

    Prostate cancer is the second leading cancer in men, killing about 27,000 in 2009.


    February 16, 2011 at 16:00 | Report abuse | Reply
  21. allen

    Do not stop testing once you have had surgery,(robotic or traditional hands on). I was operated on in 2008 with a PSA of 5.3 and a Gleason of 7. I was 0 for 2.5 years, then it started all over again. first at .03, then .12 then .24. While these don't seem particularly high, it indicated there was something still going on and the rate was increasing(which no one ever mentions– it is not always how high the PSA is but how fast it is going up!) I have just completed 37 radiation treatments and must wait til April to get results of next PSA test. So Don't fool yourself into thinking that just because that organ is out, your cured. Keep testing!

    February 16, 2011 at 16:52 | Report abuse | Reply
  22. Barryng

    The recent spate of advice coming from the medical profession has been significantly downplaying the merits of regular PSA testing. This advice is probably very valid when considering a large statistical population. However, in my very strong opinion, this advice is just plain wrong and very misguided because the statistical population it is based on consists of individuals; each one not willing to take any undue risk when it comes to dealing with something that may very prematurely shorten their life. For me, I am going to have my PSA checked at least once a year and I am going to default to a prostate biopsy for any questionable results. The risk and cost of a biopsy (very low risk, moderate to low cost, very low discomfort) is a very small price to pay for responding to the possibilty of prostate cancer (moderate risk, very high consequences). Everybody must make their own decision, certainly with their physicians advice, but no one better make the decision for me. BTW, I had a prostate biopsy last year, and, if done right by injecting lidocaine (I think) first, it is not painful at all.

    February 17, 2011 at 06:33 | Report abuse | Reply
  23. Prostate gland definition

    Prostate cancer is one of the most popular melanoma murders in britain along with us all for males, although whether it is captured early ahead of it's got spread not in the prostate ...prostate cancer

    January 25, 2012 at 21:54 | Report abuse | Reply

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