Prostate cancer screenings: Who decides?
October 6th, 2011
07:15 PM ET

Prostate cancer screenings: Who decides?

The U.S. Preventive Service Task Force is expected to recommend  next week that men not be screened for prostate cancer.

It's an issue that's been the subject of much debate. In 2010, the American Cancer Society recommended that men be allowed to decide whether they're screened for prostate cancer.  As CNN reported at the time, "Cancer specialists know that because prostate cancer is usually a slow growing disease, many men are likely to die from other causes before they would die from prostate cancer."

So it's a decision that many men wrestle with. One of them, Andrew Traver, profiled in 2009, opted for surgery and believes the treatment saved his life.

Read about him and get tips on how to make the choice and be an Empowered Patient with advice from CNN's Elizabeth Cohen.

soundoff (29 Responses)
  1. Robin

    Are you kidding me? Yes, there are side effects to treatment but do you realize prostate cancer is the second leading cause of cancer deaths in men? Also, there is a strong link within a family. We need more voices, test availability and research in regards to prostate cancer not less.

    October 6, 2011 at 19:48 | Report abuse | Reply
    • toomuchgovernment

      Remember, the 'task force' tried to outlaw mamograms at age 40 as well....this is YOUR gummint at work as a result of Obama care. There will be more of this cutting-out to follow...this is about thinning-the-herd


      May 22, 2012 at 12:00 | Report abuse |
  2. Dick

    Unfortunately, this is indeed another in a series of "findings" that will prove that there is going to be rationing of health care. What else can explain this?

    October 7, 2011 at 09:17 | Report abuse | Reply
  3. michael

    get screened and get current PSa numbers to know what yhour base line and the potential for risk. I had the exam and blood every year after I turned 40 and the PSA numbers were always the same, elevated but not in the danger zone. Thank god for my doctor who said that to be sure it would be good to have a biopsy to know what to do. the biospy was positive with the gland 100% invloved but the cancer had not broken out of the shell that contaisn the gland. I had surgeryh to remove the gland and follow up surgery. that was 15 years ago and there has been no reoccurence of anything. if I had not been screened and PSA numbers known I would have died once the cancer moved out of the gland and into the body. That is how my father died from lung cancer that came from prostate cancer that got into his lymph system.

    October 7, 2011 at 09:18 | Report abuse | Reply
  4. Glen Turner

    I too, had a father die from prostate cancer, so I read ev erything I can on testing for this type of cancer. It's obvious that there needs to be a lot more research on this type of cancer. This new informatiion is just "Food for thought", and helps us males to make a more informed decision on what we want to do in respect to own health. I welcome any information or study on this topic....Thanks!

    October 7, 2011 at 09:39 | Report abuse | Reply
  5. Frank

    The average age of people who die of Prostate cancer is 80, so it is your call if you like to get tested. It is the quality of life versus a slight increase of chance of dying caused by Prostate cancer.

    October 7, 2011 at 10:06 | Report abuse | Reply
  6. Jack

    I was diagnosed with Stage 2 P.C. at age 52. I had no symptoms nor any family history.
    It has been six years and I am cancer free.
    Were it not for the PSA test, I would most likely be dead.

    October 7, 2011 at 10:13 | Report abuse | Reply
  7. Mike

    I'm 45 and was just diagnosed with prostate cancer 2 weeks ago. I'm presently considering treatment options. My father also had PC at an early age. The missing piece here is a test to determine whether any cancer found will be aggressive or indolent. Since that doesn't presently exist, who wants to roll the dice to see whether you'll be able to coexist with the cancer? I do agree that men over 70 don't need the test; at that age, you're much more likely to die WITH PC than FROM it.

    October 7, 2011 at 13:18 | Report abuse | Reply
  8. IgM

    The problem is that the tests for prostate cancer are not very good. PSA can be elevated for other reasons, such as benign prostatic hypertrophy. The digital rectal exam (while obviously uncomfortable...) is also not 100% at picking up cancers. So let's say your PSA is elevated, are you going to get a biopsy? The problem is really that we don't always know what to do with the information from the PSA test.

    October 7, 2011 at 14:27 | Report abuse | Reply
  9. Rich

    There are OTHER tests - there are blood tests that show whether or not you're likely to have cancer in your system, there are MRIs and ultrasounds that look for changes in the prostate. Is it lumpy or smooth? Is it harder than it should be? The rectal exam can tell you enough, in some cases, to cause you to want to consider whether or not you want 15 separate holes punched into the prostate with a needle/knife device designed with a hollow shaft to obtain samples. Since trauma is known to CAUSE cancer, what does that tell you? And there are those that INSIST biopsies SPREAD the cancer. Think you know what you'd do? Think again.

    October 7, 2011 at 14:55 | Report abuse | Reply
  10. Walter

    I was 44 years old when a very mild increase in my PSA level led a urologist to recommend biopsy. The biopsy revealed that I had cancer. However, the PSAs remained low and on multiple occasions fell beneath the previous cutoff score for alarm. Nonetheless, the urologist recommended that I see a surgeon. The surgeon advised me that I would be the youngest man he ever performed the radical procedure on. He also advised me that if I did not have children then take a year see what develops. He did advised that I monitor it closely, along with my primary care provider. That started me to using the internet for something positive, and that is researching the research into the issues discussed in this forum. After hours and hours of research (I had just retired from the military) I came to the conclusion that I was not going to undergo any treatment until age 50. In the interim I continued to research this issue. I was called a fool by some and brave by others. I met with another uroligist in the interim and shared my decision. He concurred. I am now 50. I have now decided that absent significant symptoms, or a deterioration in my health, I am not going to chance any radical procedure before age 55. Am I taking a risk? Perhaps. But, I would not trade the last 6 1/2 symptom and side effect free years of my life just to learn that the darn thing was not going to kill me. Additionally, there are advances in medicine every day, literally. I am convinced that in my lifetime there will be a cure that does not leave you a living-dead person. Everyone must make their own decision. To those of you that believe that radical procedures saved you, cool. However, I think it is wrong that almost every message on this board is alarmist in nature. I am living proof (no pun intended) that diagnosis is not a death sentence. And, quite frankly, not sure I would have wanted to live with this knowledge for 6 1/2 years. I believe the research that led to this new recommendation is accurate. I also think we should not scare everyone into a rush to cut (or laser). Let other young men have to opportunity to weigh all options and get all the facts. I would make my decision again in a heartbeat!

    October 7, 2011 at 15:45 | Report abuse | Reply
    • Joseph

      Sounds very intersting. Thank you http://cnn.com for your news!

      October 9, 2011 at 17:27 | Report abuse |
  11. Bob

    I had an elevated PSA (4.8) in 2004, then a little higher in 2006. Finally, I had a biopsy in 2008 which showed minute PC on 2 of 12 cores. I was placed on active surveillance since then. Recently I had another biopsy due to a bump in my PSA. It was completely negative. Now, I doubt the cancer is gone, but the knowledge of this hangs over my head. It is truly a dilemma. More research is needed to improve diagnostics and their interpretation.

    October 7, 2011 at 20:00 | Report abuse | Reply
    • Elizabeth (Aust)

      Bob, that's my concern – some of these tests end up giving you no answers, but lots of worry. I know women diagnosed with ductal carcinoma in situ are in a similar position – a cancer you usually die with, not from...what to do?
      Most lose their breast and end up having chemo and/or radiation. Over-diagnosis is a serious and hidden risk factor with breast screening.
      Sometimes it's better not knowing, but of course, others want the lot and are happy if there is even the tiniest chance they might benefit. (even if that carries fairly high risk) Many women end up on the pap test roller coaster – it's another unreliable test and so many things can result in an abnormal result – inflammation, infection, trauma, hormonal changes and even perfectly normal changes. Testing results in massive over-detection and over-treatment – a rare cancer has been turned into a multi-billion dollar industry.

      October 9, 2011 at 23:28 | Report abuse |
  12. PORTLAND tony

    So your PSA tests are "normal" since you were in your 40's. At 65 it spikes out of the norm...do you rush into a biopsy and providing a positive results ...into surgery that at such an advanced age can be debilitating as well as life threatening. Or do you opt out for other (or no) treatment? Remember Prostrate cancer is a very slow growth cancer and unless you plan on living to 110...you. will probably die of something more mundane like "old age"......

    October 10, 2011 at 08:36 | Report abuse | Reply
  13. Oliver

    I had an annual physical in the middle of 1995 at age 58. I had an elevated PSA (4.0) and a heart arhythmia. Since there was more concern with the heart, I did further tests and determined that my heartbeat was irregular, it was not life threatening. I had another PSA in November, and found it to be 7.0. I had a 12 needle biopsy with 7 of the needles showing PC. I studied all the data I could find, and consulted a startup Prostate Cancer Support Group called Man-to-Man. I elected to have surgery, although some of the other (older) members were experimenting with other forms of treatment. Among the other treatments were Intermittent Hormone Therapy, beam radiation, needle radiation, and others. My choice was based on my relative young age and the speed at which the PSA was rising. Operative tests showed even more PC involvement than the biopsy had indicated. Fortunately, the cancer was still contained in the Prostate.
    I had both incontinence and impotence side effects. I have had 4 artificial sphincters and 2 penile implants. While they don't work perfectly, they are very serviceable. My PSA is taken every year and is undetectable. It is coming up on 16 years since my prostate surgery. From the history of the patients who are participating in the Man-to-Man support group, I would almost certainly be dead by now had I not had the surgery. Several of the Man-to-Man group I knew are dead of prostate cancer. Your statistics are suspect.
    If the logic I hear used in the report is followed, we would not ever check food for e-coli, salmonella, etc. since the risk is so small that anyone would get sick or die,(one in a million?) and detecting salmonella would cause far more harm(cost, anxiety, false conclusions and waste) than any good of the few cases that would be avoided.
    I am strongly opposed to keeping health secrets from citizens, be it PSA, or whatever. And I am strongly opposed for forcing citizens to have or not to have treatment. We own our own bodies. The government nor the medical profession nor the incomplete study scientists own us. Let us have the facts and we will make our choices and live or die with them. And don't give me the crap about we don't understand the science or the risks. That isn't your call in a free society.

    October 16, 2011 at 20:29 | Report abuse | Reply
  14. Prostate overuse

    Prostate type of cancer is a malignant form of cancer which builds up mainly within the men's prostate, a human gland found in the guy reproductive program that makes fluids which …prostate cancer

    January 25, 2012 at 22:01 | Report abuse | Reply
  15. Keith

    I decide! I won't spend the money for something I feel is unnecessary, everyone dies of something, and cancer is a natural cause. Well maybe not totally petrochemicals in food and water cause most cancers.

    May 22, 2012 at 05:16 | Report abuse | Reply
  16. Fran Swanson

    My father died of advanced, stage 4 prostate cancer from an aggressive type of tumor. He lived his last year with a very sharp mind, but a body wracked in pain to the point he was unable to walk or get out of bed due to bone mets literally from his skull to
    his feet. He also had a urinary catheter all that year. The MD's all said they were "watching it." I would never recommend to a man I loved that he follow the "watchful waiting" recommendation unless/until he knows the type of tumor he has and whether
    it is aggressive or slow growing. Dying from prostate cancer is a terrible way to go.

    May 22, 2012 at 13:54 | Report abuse | Reply
  17. Justin

    There is no question that PSA may overdetect some prostate cancers that may not be clinically significant and may not require treatment. But that is just it– getting SCREENED does NOT mean you have to be TREATED - and the USPSTF recommendations do not take this into account or (+) family history, race, or ANY risk factors and simply 'throw the baby out with the bath water.'

    It is totally irresponsible to recommend NO PSA screening for ALL men without some sort of alternative to detect the clinically SIGNIFICANT cancers that will NO LONGER be detected in YOUNG, HEALTHY men at a stage that is curable that will now be forced to DIE a PAINFUL death without early detection and treatment. We are going back 30 years in time!

    Before just 'giving up,' the task force should come up with a solution and consider a risk stratification program that wd screen and then treat only those at high risk and with high grade, high volume disease and thus avoid overtreatment of the cancers 'that don't matter' but still allow for treatment of those that do. You know, despite the government recommendations, President Obama got a PSA test during his last physical - that shd tell you something!

    May 23, 2012 at 23:49 | Report abuse | Reply
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