Prostate Cancer Screening Controversy

11/26/2011

For years, the FDA recommendation for annual prostate cancer screening has been digital prostate exams along with the PSA (Prostate-specific antigen) blood test annually starting at age 50. Recently, there has been a U.S. Preventive Services Task Force draft recommendation suggesting that the PSA test not be used for prostate cancer screening. IMSWF physicians routinely offer this test in our recommended health prevention lab profiles for men. Up to this point, the physicians haven’t changed this general recommendation, but I do agree that there is some need for discussion regarding the necessity and utility of this test. Browse the following links for more information. What is your opinion on the prostate cancer screening debate?

http://www.webmd.com/prostate-cancer/news/20100304/new-guidelines-for-prostate-cancer-screening?page=2

http://seer.cancer.gov/statfacts/html/prost.html#incidence-mortality

http://seer.cancer.gov/statfacts/html/prost.html#survival

Comments

Jim Moynihan

03/25/2012 18:00

I do not know what is right,or wrong, but haveing surivsed prostate cancer for 13 years I trust my doctor, Bert vanBeever to do whtat is right...He took care of me this long,I am not going to change now...

Ray Kordonowy MD link

04/01/2012 16:07

PSA for monitoring cancer is not controversial. The article was discussing using the PSA for screening. We diagnose prostate cancer at different stages in different ways. We are diagnosing assymptomatic prostate cancer with PSA screening (that was one of the main points in the article) but the question being asked and answered mostly to the neutral is "willl this translate to improved survival?" The evidence states fairly clearly :"yes, provided screened group is age 50-65 years; after that it doesn't appear we are improving survival. This is a moving target because each passing year under current technology and health care in the US our survival statistics are rising (life expectancy is going up at each review).

Richard Curtin, M. D.

03/26/2012 08:35

About 7 or 8 years ago I had read the literature and decided that routine PSA testing was not indicated. Dr. Gesiotto has been my doctor since he came to Fl many years ago and he agreed with my choice. Perhaps I was influenced by my older brother who had radiation in his late 70''s and has had massive bleeding problems with radiation proctitis since, with any type of anti-coagulant including aspirin. At that time I urged him to consider "watchful waiting" but he was reassured that a new computer protocol would avoid late problems.

Raymond Kordonowy MD link

04/01/2012 16:10

This leads credence to the section about future studies needing to look at watchful waiting, along with advancing the genetic science to improve individual risk assessment as to who might benefit more or less from intervention (biological behavior of the tumor). Contrary to what you brother was told, I recently asked a local Urologist if there was a reliable assessment tool for risk and his response was "no".

Charles James link

03/26/2012 14:16

1. If you don't trust your doctors recommendation. Change doctors.
2. If positive for cancer. Get 2nd independent test.
3. If still positive, ask your doctor the following "If I do nothing how long do I have." In my case if Dr, Kordonowy says 10 years, I'm doing nothing.

Dave Tompkins

03/29/2012 03:39

Based on my age (77) and a conversation with Dr. K I'll top psa testing. It's a contest; Prostate cancer? Heart attack? Falling piano?

Raymond Kordonowy M.D.

Dr. Kordonowy is board certified by the American Board of Internal Medicine and has been in private practice since 1993. He earned his degree from the University of Kansas School of Medicine in Kansas City, Kansas and completed his residency as Chief Resident at Orlando Regional Hospital System.

As Chief Resident, Dr. Kordonowy was recognized as the Outstanding Resident by the American College of Physicians. He is a member of the American Medical Association, American College of Physicians, and the American Society of Internal Medicine.

In December 2005, Dr. Kordonowy became Board Certified in the new field of Clinical Lipidology by the American Board of Clinical Lipidology. Lipidology is the specialty of diagnosis and management of cholesterol and triglyceride metabolism disorders. Cardiovascular disease risk assessment is also part of this specialty.