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Experts Debate Benefits of Early Prostate Cancer Screening

By Evelina Burnett | Published 20 Sep 2013 02:22pm | comments

September is prostate-cancer awareness month. Mississippi has the fourth highest rate of prostate cancer in the nation, and the second highest-rate of prostate cancer-related deaths.

About 2,500 men in Mississippi are expected to be diagnosed with the disease this year, but as MPB’s Evelina Burnett reports, there’s a debate over the long-term benefits of early screening.

Prostate cancer is the second most common cancer among American men. But just last year, the U.S. Preventive Services Task Force recommended against one of the common early screening tests, the prostate-specific antigen, or PSA, blood test.

Dr. Michael LeFevre is co-chair of the Task Force.

"Prostate cancer can be very slow-growing and never cause any significant harms," he says. "So the major problems associated with screening for prostate cancer is over-diagnosis and over-treatment."

Dr. LeFevre says most men with screen-detected cancer are treated even though the cancer may not cause any harm in their lifetime.

But, he says, the treatments, including radiation and, surgery or hormone therapy, can cause harm through side effects that range from bowel troubles to impotence.

Dr. Craig Dawkins, a urologist at Memorial Hospital in Gulfport, agrees that decisions about how to treat prostate cancer can be difficult. But he doesn’t think it’s right to just stop looking for the disease.

"I think the guidelines that have been suggested to us by the American Urology Association and others are reasonable," he says. "But I don’t want to throw out the baby with the bathwater here and say screening is not really that important."

Local doctors and most national groups now recommend that men know their risks and talk to their doctor about whether early screening is right for them.

Older men and men with a family history of prostate cancer are at a higher risk. African American men are also at greater risk – in Mississippi, the prostate cancer rate is twice as high among African Americans, and the death rate is three times as high as among whites.

Dr. Srinivasan Vijayakumar, deputy director of the University of Mississippi Medical Center's Cancer Institute and chair of the radiation oncology department, says the decision to screen should be personalized.

"So what I do is sit with the patient and make sure they're fully informed about what are the pros and cons of doing the screening and not doing the screening," he says. "And then come up with an individualized plan for each patient."

The American Urological Association says men 55 to 69 years old should talk to their doctor about prostate screening. Men at higher risk should talk to their doctors starting at age 40. 

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