Prostate, Ovarian Cancer Screening: When to Test?

GAPrincess · Mar 18, 2009

Prostate, Ovarian Cancer Screening: When to Test? Not So Clear

Cancer screening is in the news again. Researchers said last week that they had some potentially encouraging news about
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methods for screening for ovarian cancer, though it is far too early to endorse their use. Now, in the New England Journal of Medicine, two teams of researchers are reporting preliminaryand apparently conflictingresults from ongoing trials studying how well screening for prostate cancer works. One study found a potential benefit; the other, none. It makes for confusing headlines, and consumers might be left wondering: What am I to do? Here's a primer to help you make sense of the evidence.
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To start with the most recent news: What's going on with screening using the prostate specific antigen test?It may surprise you to know that while most men over 50 have had a PSA test, there is currently no solid evidence that doing so can save lives. There has been much anticipation about the results of two large trials studying this question, and this week we got some early reports. (Both trials will continue for several years with the aim of producing final conclusions.) One study, done in the United States, found no reduction in mortality over about 11 years from a screening program that uses the PSA test and a digital rectal exam; the other, in Europe, using just the PSA test, found a 20 percent relative drop in the death rate from prostate cancer after nine years. That translated to about 7 fewer deaths from prostate cancer for every 10,000 men screened.
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The take-away: well, not much. Most public health groups still recommend the PSA at least be offered to men over 50, with an accompanying explanation of its risks and benefits. Men with a life expectancy of less than seven to 10 years probably don't need to undergo PSA testing, Gerald Andriole, a urologic surgeon at the Washington University School of Medicine in St. Louis, said during a conference call about the U.S. study, of which he is an author . . . but we kind of knew that already.
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But finding prostate cancer early must be good, right?
Not necessarily. Finding and diagnosing any cancer early is helpful only if it actually affects the course of the diseasethat is, if finding it early means you can save lives, says Robert Smith, director of cancer screening for the American Cancer Society. It's possible, however, for screening to catch slow-growing cancers that would never be lethal and yet miss aggressive tumors that spring up and spread in between screenings. In fact, there's pretty broad agreement that doctors treat some men for prostate tumors that never would have caused them problems, but it's not clear how many. It's also unclear how to pinpoint which newly diagnosed cancers are potential killers and which are, as Andriole called them, "toothless lions." It's an important question to answer, not in the least because the potential side effects of prostate cancer treatment, including impotence and incontinence, are life-altering. It's even possible that treatment itself could shorten a patient's life by causing radiation damage or other delayed effects.
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RickG · Mar 18, 2009

For prostate cancer to be curable it has to be detected in the early stages . This can only be done by screening . If symptoms show up the cancer has spread to other organs and is beyond the curable stage .

Prostate cancer usually doesn't produce any noticeable symptoms in its early stages, so many cases of prostate cancer aren't detected until the cancer has spread beyond the prostate. For most men, prostate cancer is first detected during a routine screening such as a prostate-specific antigen (PSA) test or a digital rectal exam (DRE).
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http://www.mayoclinic.com/health/prostate-cancer/DS00043/DSECTION=symptoms

Many doctors recommend screening after age 50 , 40 if African American or there is a history of prostate cancer in the family . This man had no symptoms , just thought he should be screened at age 40 .

I had a PSA level of 41, so went in for a biopsy of the prostate and all 15 samples came back with cancer this lead to the CT scan and a bone scan a week ago. The Bone scan I am being told showed 3 worrisome spots. The Oncologist gave me the news 2-3 years for survival not what a 40 year old in relative good health with a 8 and 11 year old wants to hear.
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