The U.S. Preventative Services Task Force’s recent recommendation against routine PSA screening for prostate cancer in healthy men represents a fundamental philosophical statement about science, medicine, and human psychology and life that needs to be clearly exposed so that it does not appear cloaked in the certainty of a scientific fact.

While not completely devoid of controversy, the “fact set” underlying the widely different interpretations and recommendations regarding PSA-based prostate cancer screening are largely established. Prostate cancer is a major public health problem in this country. In 2010, there were approximately 217,730 new cases of prostate cancer, and 32,050 men died from prostate cancer, the second leading cause of cancer deaths in this country. Against this bleak backdrop, we know that population based PSA screening saves lives. Period. When studied in large, well performed randomized, clinical trials, PSA-based screening results in anywhere from a 20% to 50% reduction in the risk of dying from prostate cancer. However there are caveats that increase the complexity of the interpretation of this seemingly clear result.

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New Prostate Blood Test May Be the Answer to the USPSTF’s Negative Outlook on PSA Screening

USPSTF’s recent downgrade of PSA screening

The USPSTF’s recent downgrade of PSA screening in healthy men to a D rating has generated a firestorm of controversy from both screening foes and advocates about the merits of this decision, which could affect the health and well being of men who are confused by the mixed messages surrounding this emotionally charged debate.

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A recent study published in The Journal of Urology suggests that prostate cancer patients treated by more experienced urologic surgeons achieve improved results.

Prostate cancer is the most common non-skin cancer in American men, who have about a 1 in 6 chance of being diagnosed with this disease in their lifetime. Radical prostatectomy, performed either through a standard incision, or more recently through a robotic-assisted minimally invasive approach, is a surgical procedure in which the surgeon attempts to remove the cancer-containing prostate gland, without damaging the surrounding structures that control sexual and urinary function.

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Prostate Cancer: Dawn of a New Era

As Director of the Baylor Prostate Center for 15 years, and now Director of the Vanguard Urologic Institute and the Texas Prostate Center since 2007...

"...I have dedicated my life to the improvement of care for patients with prostate disease, primarily prostate cancer."

Despite widespread success in reducing the mortality due to prostate cancer over the past two decades, new data from randomized trials performed in this country and in Europe are leading to a sea of change in the way we care for men concerned about their risk of prostate cancer and committed to taking the necessary steps to maximize their chances of living a full life with minimal impact from this disease. Achieving this requires the right balance at every step of the process, including how often to perform PSA-based screening, when to employ methods at prostate cancer prevention and which make the most sense, when to perform a prostate biopsy and when necessary how to perform it, and what to do when prostate cancer is detected and when it is not. The answers to all of these questions have become more confusing than ever to the average man.

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