Prostate Cancer Screening
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Is Screening Right For You?
It all begins with a discussion of the risks ad benefits of prostate cancer screening - shared decision making. Long-term data shows benefit to prostate cancer in many patients but may be harmful in some people. Current guidelines discourage screening if a man’s life-expectancy is less than 15 years.
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What's Involved In Screening
Screening is all about risk assessment. The tools used to do this continue to evolve. PSA, prostate exam, imaging and genetic tests all play a role. The results of this assessment should lead to action whether it be reassurance and a plan for follow-up or a biopsy.
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Grow it.
It all begins with an idea. Maybe you want to launch a business. Maybe you want to turn a hobby into something more. Or maybe you have a creative project to share with the world. Whatever it is, the way you tell your story online can make all the difference.
Is Prostate Cancer Screening Right For You?
It all begins with an idea. Maybe you want to launch a business. Maybe you want to turn a hobby into something more. Or maybe you have a creative project to share with the world. Whatever it is, the way you tell your story online can make all the difference.
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The cancer may never progress and cause any problems BUT can cause suffering and/or death.
The cancer may progress so slowly that a man dies of another condition before the prostate cancer has an opportunity BUT some men will live long enough that the cancer has an opportunity to cause suffering and/or death.
The cancer may have spread prior to diagnosis rendering it incurable and thereby removing the benefit of screening BUT evidence of incurability may only be apparant in hindsight - sometimes years after one must make a decision on whether to receive (or forego) radiation or surgery.
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Curative treatments for prostate cancer have the potential for benefit and harm. Occasionally the complications from the treatment can be devastating. Radiation and surgery can cause irreversible problems with:
Urinary function.
Sexual function.
Bowel function.
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Men need to live long enough to benefit from treatment. Many men with prostate cancer will 'die with it instead of from it' without any treatment. Accurate assessment of life expectancy is challenging over the 10+ year time horizon that prostate cancer screening requires to be of benefit. Younger men are more likely to benefit from screening. Older men are less likely to benefit from screening.
Current guidelines recognize this issue by:
Recommending against screening in men who do not have a life expectancy of at least 15 years.
Recommending against curative treatment in men who do not have a life expectancy of at least 10 years.
It bears emphasizing that screening and treatment of prostate cancer relies on prediction of the future. An inherent property of prediction is uncertainty. In the absence of certainty, the best that we can do is make educated guesses with the information at hand. Information also changes with time. This is not just a problem with prostate cancer screening but with virtually everything in life - the future is alwaysuncertain to some degree. In prostate cancer screening this results in an unavoidable tension between overdiagnosis and underdiagnosis which can, in hindsight, be a source of overtreatment and undertreatment. The aim is to strike the right balance for the each patient at a specific time in their life.
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These links provide additional information and should be reviewed by men who want to understand more detail.
Prostate Cancer Canada: Prostate Cancer Basics: Screening and Diagnosis
American Cancer Society: Testing for Prostate Cancer
American Society for Clinical Oncology (ASCO) Prostate Cancer Screening Decision Aid Tool
Make it stand out.
It all begins with an idea. Maybe you want to launch a business. Maybe you want to turn a hobby into something more. Or maybe you have a creative project to share with the world. Whatever it is, the way you tell your story online can make all the difference.
