health & wellness

DETROIT ZOOLOGICAL SOCIETY

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Screening. Debatr

New guidelines for prostate cancer testing confuses patients.

Ruthan Brodsky
Contributing
Writer
I

rostate cancer is the second
most common type of cancer,
after skin cancer, found in
American men. It is also the second
leading cause of cancer death, after lung
cancer, in men. One man in seven will
get prostate cancer during his lifetime,
and one man in 36 will die of this dis-
ease.
Prostate cancer can be a serious dis-
ease, but most men with prostate cancer
don't die from it. In fact, more than 2.5
million men in the United States who
have had prostate cancer at some point
are still alive today. According to the
American Cancer Society, the survivor
number is more than 2 million.
Yet, in 2014, the society estimates
about 233,000 new cases of prostate
cancer and about 29,480 deaths from
prostate cancer.
Even with this data, there is no

p

unanimous opinion in the medical com-
munity regarding the advantages of
prostate cancer screening.
Those who advocate regular screen-
ing promote the theory that finding
and treating prostate cancer early offers
men more treatment options and bet-
ter potential for cure from the disease.
Those who advocate against regular
screening believe there is an over-
diagnosis of prostate cancer leading to
unnecessary treatments and complica-
tions.
The prostate is a walnut-sized male
sex gland located between the bladder
and rectum. A blood test called pros-
tate-specific antigen (PSA) was once
regarded as the best way to help detect
prostate cancer early and was a major
focus of cancer prevention for decades.
For example, in 1992, the American
Cancer Society recommended that PSA
testing be done every year starting at
age 50 or at age 40 in populations such
as African Americans because they are

at higher risk of getting the disease and
dying from it.
Approved by the Food and Drug
Administration (FDA) in 1986, the PSA
test measures the blood level of PSA,
a protein produced by the prostate
gland. The blood level of PSA is often
elevated in men with prostate cancer.
The test has also been widely used to
monitor men who were diagnosed with
prostate cancer to see if their cancer has
recurred after treatment or has lowered
due to treatment.
In 1994, the FDA approved the use of
the PSA test in conjunction with a digi-
tal rectal exam to test men who had no
symptoms of prostate cancer.
However, there are other conditions
that can cause a man's PSA level to rise,
such as prostatitis (inflammation of the
prostate) and benign prostatic hyperpla-
sia (BPH) or enlargement of the pros-
tate. There is no evidence that either of
these conditions lead to prostate cancer.
To complicate the issue even more,

Participants in the Michigan Institute
of Urology Men's Health Foundation's
sixth annual Run for the Ribbon in June,
the largest prostate cancer walk in the
nation. Funds were donated to Karmanos
Cancer Center and Oakwood Healthcare
Foundation to assist under- and
uninsured prostate cancer survivors.
The foundation also created a fund at
the William Beaumont Foundation for

prostate cancer research.

some men have prostate cancer without
elevated PSA levels.
"Until recently, many
doctors and large pro-
fessional organizations
recommended yearly
PSA screening for men
at age 50," said Dr.
Michael Lutz, M.D., of
Birmingham, a part-
Dr. Michael
ner in the Michigan
Lutz
Institute of Urology

Debate on page 76

September 25 • 2014

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