05 March 2010

Men should take lead in deciding to test for prostate cancer

The new American Cancer Society (ACS) issued updated screening guidelines provide detailed advice on the kind of information that should be discussed regarding the pros and cons of the screening tests. The guideline's authors recommend an honest discussion of all issues, including the prostate-specific antigen (PSA) blood test and a digital rectal exam, and point out the need to distribute educational materials, including brochures or a video, explaining uncertainties, risks and benefits of the tests.

The ACS recommends the following:

  1. Men age 50 who are in relatively good health and with no symptoms of prostate cancer should be active in making an informed decision with their physician about prostate screening.
  2. African-Americans and men with a father, brother or son diagnosed with prostate cancer before age 65 - should begin that informed-decision talk earlier, at age 45. Those at higher risk, such as men with multiple family members affected by the disease before age 65, should start talking about screening at age 40.

For men that are unable to reach a decision about screening after these conversations, the ACS guidelines recommend that a doctor will decide whether or not to screen based on knowledge of a patient's health preferences and values. After this decision to screen is made, the new guidelines make the digital rectal exam portion of the testing optional. However, they say it is acceptable to extend the period between screenings for men with low PSA levels.

Even when these tests detect cancer, due of limits of both PSA and the digital-exam method, physicians often can't tell how dangerous the cancer is without further tests or medical procedures. It is important to note that some prostate cancers grow slowly and never cause any problems; others may grow aggressively.

However, regarding prostate cancer treatment options, physicians and cancer-prevention experts urge the need for better ways to detect and treat early-stage prostate cancer, particularly the need to make difference between actively growing cancers that do require treatment and those that are not. It is well-known that the American Urological Association, insists that shared decision-making should involve personal data that is more in-depth than age, such as ethnicity, family history, previous biopsy characteristics and other factors.

But, until new screening tools are available, it is crucial for all care providers and cancer-prevention program directors give men the opportunity to decide whether they wish to pursue early detection for this disease.

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SOURCE: UAB Comprehensive Cancer Center



NOTE: Issues on this site regarding prostate cancer and treatment options, are provided for information only, and are not meant to substitute for the advice of your own physician or other medical professional. Prostate-Report.org does not endorse any specific product, service or treatment.





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