Two new and much-publicized prostate cancer studies appear to offer conflicting results about the effectiveness of PSA blood tests used to screen for the disease.
In one study of nearly 77,000 American men, there was no apparent reduction in prostate cancer deaths associated with PSA (prostate specific antigen) screenings. But another study of about 182,000 European men showed a 20 percent reduction in mortality.
Christopher Coogan, MD, a urologist at Rush University Medical Center, says results from the studies — published in March in the New England Journal of Medicine — don't put the controversy to rest regarding PSA screening.
He notes that neither of the studies is final, so it may be too early to draw conclusions. The methodologies of the two studies also are different, and in some cases the follow-up may have come too early to detect a benefit from screening.
"I'm talking people out of it more than I talk people into it," he says of the PSA test, particularly if they're older than 75 or have other serious health issues. "But having said that, I think screening is beneficial."
Elevated levels of the PSA protein in blood can be a sign of prostate cancer, but they don't necessarily mean someone has the cancer. In fact, most men with high PSA levels don't.
Even after a prostate cancer diagnosis, choosing the appropriate course of treatment — such as surgery, radiation or hormone therapy — can be challenging due to possible side effects including incontinence or impotence. Sometimes closely monitoring the cancer may be the appropriate option.
The key is consultation with a physician, who can help decide the most appropriate course depending on a patient's age and the type and aggressiveness of the cancer.
"That's really where I think the art comes in," Coogan says.
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Please note: All physicians featured in Discover Rush Online are on the medical faculty of Rush University Medical Center. Some of the physicians featured are in private practice and, as independent practitioners, are not agents or employees of Rush University Medical Center.
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