Experts Divided Over New Prostate Cancer Screening Recommendations

NEW YORK (CBSNewYork) — A national task force that once recommended against a test for prostate cancer is making a major shift.

New proposed guidelines suggest the PSA blood test may be beneficial after all. But as CBS2’s Dr. Max Gomez reports, some experts say the new guidelines don’t go far enough.

Prostate cancer mortality dropped nearly 40 percent over the last decade, which many medical professionals attribute largely to early detection with the PSA blood test.

The trouble is, the test yields many false positives, leading to unnecessary biopsies, surgery, and radiation — precisely what the new recommendations have set out to balance.

Larry Blumberg’s life changed when his doctor diagnosed him with prostate cancer last year.

“He said we are in time,” Blumberg said. “I’m not sure if we could have been in time if we had done this a year or two from now.”

[graphiq id=”hjdRgCBXpLD” title=”Incidence and Mortality of Prostate Cancer in the United States” width=”600″ height=”455″ url=”https://w.graphiq.com/w/hjdRgCBXpLD” ]

The 69-year-old’s cancer was found after Blumberg had a PSA blood test, even though he showed no symptoms.

The US Preventative Services Task Force had previously recommended against the test. Now, based on the latest research, the group says men 55 to 69-years-old should have a conversation with their doctor and make a personalized decision about PSA screening.

“Men can reduce their chance of dying from prostate cancer and reduce their chance of having cancer that spreads throughout their body,” task force chairwoman Dr. Kirsten Bibbins says. “These are really important benefits but they occur in a small number of men.”

The concern is that the PSA testing results in over-diagnosis and over-treating cancers, which can lead to serious issues like impotence and incontinence — and the majority of prostate cancers are so slow growing that they will not ever become life-threatening.

Urology Chairman at NYU Langone Medical Center Dr. Herbert Lepor says advances in detection, treatment, and monitoring are helping men avoid over-treatment.

“We have better tools to assess the aggressiveness of the cancer and now we have some innovative therapies so we can offer the menu of options, from surveillance, to focal therapy, to whole gland therapy,” Dr. Lepor said.

Blumberg says he chose surgery to remove his prostate. He’s had some side effects, but says they’re worth it.

“The side effects are nothing compared to the fact that I’m going to live a long life, enjoy my kids and my grandchildren,” he says.

The task force continues to recommend against prostate cancer screening for men 70 and older, saying there’s not enough evidence for a benefit in that group. Right now, the new guidelines are a draft. The final recommendations could be decided by early this summer.

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