Memorial Robotics for Prostate Cancer

Memorial Robotics for Prostate Cancer
Memorial Medical Bldg. East
725 Glenwood Drive, Suite E790
Chattanooga, TN 37404-1163
(423) 495-3068

USPSTF Recommendations for Prostate Cancer Screening with PSA

 

SCREENING FOR RISK and EARLY DETECTION

Response

In May 2012, the US Preventative Services Talk Force recommended against the use of PSA screening for prostate cancer in all men of all ages. Their recommendation ignored the very powerful and persuasive arguments and evidence provided to them by a wide variety of medical societies devoted to preventing cancer and cancer death. Their recommendation is not only terrible medical advice, it is irresponsible and dangerous and should be ignored.

Consider:

  • Prostate cancer is the most common non-skin cancer in men and the second most common cause of cancer death.
     
  • Approximately 200K men diagnosed each year and 30K-35K deaths each year.
     
  • Early prostate cancer is asymptomatic. Symptoms are usually caused by metastases or advanced disease
     
  • 5 yr survival for early stage prostate cancer with treatment is 100% 5yr survival for late stage, metastatic
    prostate cancer is less than 30%.
     
  • The only way to have a meaningful impact on the natural history of prostate cancer is to find it in the early stages, which means we have to look for it. We look for it with DRE and PSA

 

How did they get this wrong?

  • The panel did not include a urologist, radiation oncologist or medical oncologist. They had no organizational knowledge or memory of how the clinical care of prostate cancer has evolved over the last 20 years. They relied upon a meta analysis of 5 studies, 3 of which were badly flawed. They were therefore seemingly unaware of the successes achieved by early detection and treatment.
     
  • Prior to 1990 only 35% of men with prostate cancer had any chance at curative intervention. Today it is greater than 90%.
     
  • Since 1990, there has been a 41% decrease in prostate cancer mortality and a 75% reduction in men presenting with metastases.
     
  • The AUA and NCCN continue to recommend the use of PSA screening as part of an informed decision process between patient and physician.
     
  • The real issue is the thoughtful and responsible interpretation of PSA as one risk factor among several for estimating a man’s risk for having prostate cancer. The goal is to avoid over diagnosis and over treatment without missing important clinically significant cancers. What is needed is a more reliable method to distinguish trivial, indolent cancers from lethal cancers.

For further reading please go to www.AUAnet.org/USPSTF

Our Address

Chattanooga, TN Urologist
Lee Jackson, M.D.
725 Glenwood Drive, Suite E790
Chattanooga, TN 37404
(423) 495-3068

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