Prostate screening may cause more harm than good

(NBC) - A government advisory panel says most men should not get one the most common tests available to detect prostate cancer, a recommendation that could drastically revamp the way men over 50 are treated.

After a routine blood test showed William DePaula had prostate cancer, he and his doctor opted to remove the cancerous tissue with surgery.

"I wanted them out of my system," he said.

The aggressive treatment may have been a lifesaver for DePaula, who has a history of the cancer in his family. But for most healthy men, a government advisory panel now says a routine prostate-specific antigen blood test is unnecessary.

"There have been several studies looking at prostate cancer screening," said Dr. Otis Brawley of the American Cancer Society. "The majority of those studies have failed to show that prostate cancer screening saves lives."

The PSA test looks for a protein released by the prostate when cancerous cells are present. Most men are never affected by these cells, however, and the PSA test does not show how aggressive the cancer is. In addition, treatments like surgery can leave men incontinent and impotent.

Some experts warn that certain medications used to treat prostate cancer can also increase the risk for heart disease, killing patients long before they'd ever die from the cancer.

"A man actually trades cause of death: cardiac disease earlier instead of prostate cancer death later," Brawley said.

He suggests that could be why the death rate for prostate cancer has declined over the past 20 years. But other renowned specialists disagree, standing by the PSA test.

"Men with the most aggressive cancers actually have a pretty good survival at 15 years," said Dr. Eric Klein of the Cleveland Clinic. "That's the benefit to screening, is finding those high grade, potentially lethal cancers."

The U.S. Preventive Services Task Force will make the new PSA recommendations, which aren't yet final.

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