Q: The American Cancer Society recommends that men begin talking to their doctors about prostate cancer screening at age 50. Why is prostate cancer screening important?
Dr. Lerner: In the era of prostate-specific antigen (PSA)-based screening—a blood test that can help detect prostate cancer—the survival rate for the disease has improved by more than 40 percent. You can’t prevent prostate cancer, and while we have improving therapies for treating metastatic prostate cancer, we don’t have a cure once the cancer has gone beyond the organ. What we’re left with is early detection through screening, followed by early intervention such as active therapies including robotic surgery or radiation.
Q: Who should get the screenings, and who should not?
Dr. Lerner: The target for this screening should be men with at least a 10- to 15-year life expectancy. In addition, men at high risk—these include men who have a first-degree relative diagnosed with prostate cancer prior to age 62 (these men are at three times the risk of developing the disease), and men of African-American descent (who have the highest incidence of prostate cancer and prostate cancer-related mortality in the world)—should also be screened.
Q:What considerations need to be made before you decide to get a screening?
Dr. Lerner: Are we diagnosing men with prostate cancer who otherwise would not be harmed by it but are potentially harmed by treatments that are performed with the intent to cure? Is the cure more toxic than the disease? Doctors and patients should go over the risks and benefits of the screening, as well as the potential benefits of being diagnosed with something that’s curable.
Q: What else should men know about prostate cancer testing?
Dr. Lerner: The better informed the patient is, the more comfortable he and his family are with decisions regarding his health. An open discussion between the patient and his physician with regard to screening is highly recommended.