Commonhealth offers an interview Dr. Philip Kantoff, director of Dana-Farber’s Lank Center for Genitourinary Oncology. He speaks out against the recent decision by a federal task force not to recommend the use of PSA tests to screen for prostate cancer.
The panel has gotten the message wrong. What I think is the issue is that you need to dissect this problem into its component parts. And that is:
Number 1, that using PSA detects cancer earlier and saves lives.
Number 2, there are many men who don’t need to get screened and are getting screened, and we need to control that. We need to rein that in.
Number 3, there are many men with elevated PSAs who don’t need to get a biopsy for a variety of reasons. And we need to understand that more, and understand who with an elevated PSA does not need a biopsy. That issue needs to be studied much better.
In addition to the USPSTF recommendations, the NYTimes offered a story this weekend with the headline — Can cancer ever be ignored? Tuesday, the paper ran an editorial entitled “”https://www.nytimes.com/2011/10/11/opinion/questioning-prostate-cancer-tests.html?ref=opinion">Questioning Prostate Cancer Tests."
But, on the letters page, Mass General’s Dr. Donald Kaufman defends the tests:
Used correctly, the P.S.A. test is invaluable. It allows us to identify men who merit a biopsy. A biopsy that reveals cancer should not trigger a radical prostatectomy, with its potential for dire, life-changing side effects. Rather, it should lead to a discussion between doctor and patient and a careful analysis of whether any treatment at all is required.
Active surveillance should always be considered before any treatment is advised. Many men with proven cancer will never require treatment.