PSA exams halted for older men
It does not please me in the least to say, "I told you so." But according to a guidance alert just issued to doctors, prostate screenings should halt for those over the age of 75.
For years I've said it—and caught a lot of flak for it. But even when you get "vindication" for your views—based on the available science—I can't say I'm pleased. I think of all of those men out there who have gone through unnecessary suffering due to PSA screenings that are both unpleasant and ineffective.
The PSA has been a pretty lousy predictor of prostate cancer. The overall mortality rate from prostate cancer has dropped only about 6 percent to 8 percent since PSA testing first began about 15 years ago. Meanwhile, the number of cancer diagnoses has more than doubled, resulting in a great deal of unnecessary treatment, cost, and suffering for many men. But the mainstream has been slow to study these numbers—let alone acknowledge them and rule in the favor of common sense.
Well, finally they've caught on. The U.S. Preventive Services Task Force reviewed all the available research and found that the benefits for routine screening are "small to none" in this age group. But the treatment was more than many men bargained for—including life-altering side effects that included incontinence and impotence.
The fact that you have prostate cancer does not necessarily mean it will kill you. Most men die of something else well before the prostate cancer becomes life threatening, because most prostate cancers are slow growing. Men with just localized prostate cancer that is untreated have a long-term survival rate that is high. But the sad fact is that many men are put through unnecessary treatment when the wait-and-see approach makes more sense.
If you're a man over the age of 75, this latest guidance is good news for you—sadly, it took way too long.
