Prostate Screening: Does it Help? Does it Hurt?

It’s now three weeks since my biopsy and I’m pretty much back to normal.  All of the annoying side effects are finally gone.  I am really not looking forward to ever having another biopsy.  It wasn’t horrible, but definitely not something I wish to repeat.  In other recent news:

From the New York Times

The PSA blood test, used to screen for prostate cancer, saves few lives and leads to risky and unnecessary treatments for large numbers of men, two large studies have found.  

The findings, the first based on rigorous, randomized studies, confirm some longstanding concerns about the wisdom of widespread prostate cancer screening. Although the studies are continuing, results so far are considered significant and the most definitive to date.


Dr. Peter B. Bach, a physician and epidemiologist at Memorial Sloan-Kettering Cancer Center, says one way to think of the data is to suppose he has a PSA test today. It leads to a biopsy that reveals he has prostate cancer, and he is treated for it. There is a one in 50 chance that, in 2019 or later, he will be spared death from a cancer that would otherwise have killed him. And there is a 49 in 50 chance that he will have been treated unnecessarily for a cancer that was never a threat to his life.

Prostate cancer treatment can result in impotence and incontinence when surgery is used to destroy the prostate, and, at times, painful defecation or chronic diarrhea when the treatment is radiation.


I think it’s clear we need more accurate diagnostics, especially ones that are less invasive than a biopsy.  There is an obvious need to know how large and aggressive a cancer is before deciding if radical treatment is necessary.


Update: The New York Times added this article today

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