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Metastatic Prostate Cancer on the Rise; Sharp Decline in Screening to Blame

Posted on Friday, November 6, 2020
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by AMAC, John Grimaldi
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cancerWASHINGTON, DC, Nov 6 — Eight years ago the U.S. Preventive Services Task Force was recommending against PSA testing for prostate cancer.  And now a new analysis by the Centers for Disease Control [CDC shows that metastatic prostate cancer is on the rise, reports the Association of Mature American Citizens [AMAC].

The study showed that “although approximately three-fourths of US men with prostate cancer have localized stage at diagnosis, an increasing number and percentage of men have received diagnoses of distant stage prostate cancer. Survival with distant stage prostate cancer has improved, but fewer than one-third of men survive 5 years after diagnosis.”  [Localized prostate cancer remains in the prostate gland while distant stage prostate cancer is metastatic; it spreads to other parts of the body.]

Meanwhile, research conducted by Urologists, Dr. Navin Shah and Dr. Vladimir Ioffe, shows that “after the United States Preventive Services Task Force (USPSTF) recommended against PCa [prostate cancer] screening, there was a trend of increasing prostate cancer diagnoses with higher grades despite a decrease in overall biopsy rates. We found that in 2019, compared to 2010-12, the number of biopsies decreased by 45% while the diagnosis of PCa increased threefold.”

According to Dr. Shah: “Prior to 2012, annual PCa screening reduced PCa mortality by 50%. Since the USPSTF recommended against PSA- and DRE-based PCa screening [Digital Rectal Examination], 50% of primary care physicians do not offer PCa screening.”

In its report, the CDC noted that “In 2018, USPSTF issued a new recommendation stating that prostate cancer screening for men aged 55–69 years should be an individualized decision based on personal preferences when weighing the benefits and harms of screening, and several professional organizations have similarly recommended shared decision-making for men deciding about prostate cancer screening.  Understanding incidence and long-term survival by stage, race/ethnicity, and age could inform messaging related to the possible benefits and harms of prostate cancer screening and could guide public health planning related to treatment and survivor care. Further research is needed to examine how social determinants of health affect prostate cancer diagnosis and treatment; findings should inform interventions to decrease disparities in outcomes.”

So why did the USPSTF recommend against PSA testing in the first place?  According to a Harvard Medical School report there may have been three reasons:

“American man’s risk of developing prostate cancer at some time in his life is at least 30%, yet his risk of developing clinically important disease is about 17%, and his risk of dying from the disease is only 3%. In other words, many prostate cancers are harmless even if untreated; a man is much more likely to die with prostate cancer than from it.

“The PSA test cannot tell which cancers are likely to be indolent and which are aggressive. That means routine screening will detect many tumors that would never cause harm, a problem called overdiagnosis.

“About three of every four men with PSAs above 4.0 ng/ml do not have cancer. That’s because benign prostatic hyperplasia (BPH), infections, inflammation, and other conditions can boost PSA levels, while many other conditions can lower PSA readings.”

About AMAC: The 2.1 million member Association of Mature American Citizens [AMAC] [https://amac.us] is a vibrant, vital senior advocacy organization that takes its marching orders from its members. We act and speak on their behalf, protecting their interests and offering a practical insight on how to best solve the problems they face today. Live long and make a difference by joining us today at https://amac.us/join.

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Dan W.
Dan W.
3 years ago

The good news is that both urologists and radiation oncologists have more tools in their toolboxes and can offer more treatment options than were available ten years ago (especially if your prostate cancer is caught in Stage 1 or Stage 2 while it is still localized in the prostate).

If your PSA is increasing at a faster than expected rate, your next step can now be an MRI rather than a biopsy. After the MRI, if you choose to have a biopsy, you can now choose an option where the biopsy goes through the perineum rather than through the rectum which means an almost zero chance of infection and a much more thorough result.

Also, if you catch the cancer in Stage 2 and decide to proceed with treatment, radiation can be as effective as surgery for treating your cancer (and a SpacerOAR gel is now available for additional protection if you choose radiation).

In any case, depending how aggressive the biopsy reveals your cancer to be, you should get opinions from both urologists who specialize in prostate cancer surgery and radiation oncologists; weigh the potential side effects and your projected longevity from both surgery and radiation and then decide which course of treatment works best for you.

Tom
Tom
3 years ago

Horseturds! The PSA testing is severely inaccurate in many instances. Life style changes will do more to stop or prevent cancer. The medical mafia needs more testing to fill the coffers. Endless testing, drugs and procedures rule the day. What about all the things that lead to cancer? The same knuckleheads promoting the fake pandemic and lockdowns are the same knuckleheads that cry about not enough screening. Make up your stupid minds. We blindly accept whatever Pharma and doctors tell us and we never get the other side of the story…because there is no profit in it for the ultra greedy medical mismanagement machine.

BCox
BCox
3 years ago

IF you have had higher than expected PSA tests please consider an MRI and a DIRECTED biopsy if indicated. There are recently FDA approved treatments such as HIFU (high intensity ultrasound), FLA (focused laser ablation) and TULSA (Transurethral Ultrasound Ablation) (research The Busch Center,Alpharetta, GA) that are organ sparing treatments for you to consider. Every case is different and you are your best advocate. I speak from personal experience, my tumor was located in an area that was unlikely to be detected through a normal biopsy. Based on biopsy pathology I was a good candidate for organ sparing procedures. Three months post treatment PSA down from 10.7 to .81

Blake
Blake
3 years ago

There a lot of treatments scenarios and options for potential prostrate cancer if found early. As one who has had it and received multiple treatments over the last ten years I highly recommend you get tested.

My father had cancer when he died at 74 but not from it. My grandfather died from it at 80.
And a Duke University cell research team could not find a heritable gene for it.

Due to my situation my younger brothers and brother in law were able to have the prostrate removed, minimizing significant tests and treatments. Today, for me they still monitor and find no issues to treat.

Many doctors recommend you get the simple test around the age of 60.

Elizabeth
Elizabeth
3 years ago

Read the Israeli research 1960’s and 70’s on causes for the rise in prostate Cancer and you will find some surprising underlining causes that have more to do with the feeling of helplessness in men and situations they cannot control (like incoming mortar attacks) and now COVID, unemployment and threat of loss of life and control. Once these causes pass the rates of PC dramatically decline. The world wide situation is raising havoc with stress that can kill. Or is that too unscientific for men and woman of science to believe?

Mike Swanson
Mike Swanson
3 years ago

I had a kidney stone in 2012, and during the initial testing process by my urologist, he found my PSA to be slightly elevated. I had a biopsy and it confirmed a small section of cancerous growth on my prostate. I discussed the options with my doc: 1. Perform surgery, 2. Go through radiation, 3. Do nothing. I decided to go through radiation. After treatment my PSA has dropped to well below 1. I will never regret my decision, and I thank God for that kidney stone!

Sam
Sam
3 years ago

“Eggs are bad for you.” “Eggs are good for you!” “Coffee is bad for you.” “Coffee is good for you!” “Get a PSA.” Don’t get a PSA.” “GET A PSA!!!” I can’t keep up with all the ‘rule’ changes…….

David
David
3 years ago

A PSA discovered my cancer at an advance stage. When my prostate was removed it had just barely started to masticate and I’m lucky as another month or two it would have traveled more than just slightly out of the prostate. Even a false reading is ok in my opinion as follow up tests will show its not cancer. Better to be safe than sorry. Yes the prostate cancer in the prostate may not kill you but once it masticates and travels to the bones or organs it most likely will.

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