To screen or not to screen
If you haven’t heard by now the United States Preventative Services Task Force released their most recent guidelines on prostate cancer screening. The verdict is a first: they recommend against routine screening for prostate cancer in men who don’t have symptoms.
The USPSTF has been tiptoeing around this recommendation for years, with the recent past being a recommendation that screening (typically a PSA and rectal exam) be optional.
The reason is that most men die with prostate cancer than because of prostate cancer. The workup and treatment for a condition that most often does not lead to major problems can often lead to major problems.
The vast majority of physicians have come out to refute the recommendations, as have the cancer organizations. Their argument is that they have seen cases where a screening PSA test picked up a previously undiscovered cancer and patients were able to have therapy right away. It is certain that some of these men would have suffered significant morbidity and even mortality as a result of their cancer, and the screening test in these individual cases was a success. But what the USPSTF is saying is that more men with a positive PSA wind up suffering from lifelong, quality of life destroying impotence, urinary/bladder issues or chronic pain; all for treating a condition that was likely to never be an issue.
It’s a tough call, but the evidence would support men with no symptoms and no family history to pass on screening for prostate cancer.
I recently saw a man who was suspected of having prostate cancer due to an elevating PSA. Before doing a biopsy, he wanted to focus on lifestyle change and appropriate supplemenation and track the PSA. Two months after eating whole foods, kale-loaded smoothies, tomato sauce (lycopene), green tea, AHCC (from mushrooms) and genisten (component of soy), his PSA dropped to almost nothing!
My advice, if you’re a man with no urinary/prostate symptoms, pass on the prostate cancer screening and start focusing on lifestyle measures that will help your body either keep the cancer cells at bay or from not showing up at all. Have a green tea on me!
KevinMD wrote a great blog on this very subject:
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Dr. Jeffrey Gladd
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Dr. Jeffrey Gladd graduated from Indiana University School of Medicine in 2001. He then went on to train in family medicine...
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