Prostate Cancer Screening -- Necessary or Unnecessary?

I've always heard that the conventional wisdom was that when you turn 40, you should start planning to get a prostate cancer screening.

But my doctor told me today that the conventional wisdom may not be that wise.

I'm fortunate to have a physician that is a no-B.S. professional. He will tell me straight up what's up; he won't treat a patient who is not sick; and he is really skeptical of insurance and pharmaceutical companies to say the least. He's kept me and so many others healthy because of his attitude toward his practice and his patients. Needless to say I've learned to trust the guy with my well-being.

So when I told him I turned 40 recently and that I thought I should get a PSA test, he told me "not so fast" and pointed out to me that getting the test may lead to proper treatment and prevention, but it has just as much chance of leading to overtreatment and unnecessary complication.

My father once had prostate surgery, but my doctor says even if it's hereditary, it doesn't mean I'll be diagnosed with it. Indeed, as I've done my research I'm finding many in the medical community questioning the necessity of constant prostate screening.

I mean, I have no reason to think I may come down with prostate cancer, and if I take a test and they find something that might not even be cancer and take treatment then I may well suffer adverse effects.

On the other hand, if I take it and they do find something, I could either a) live with it and likely die 60 years from now of something else; b) take the treatment and save my life; or c) die of prostate cancer within the next five years.

The doctor's argument did sound reasonable, and he didn't tell me not to get the PSA, he just said I could choose to do it or not to and that it might not really make any difference long term if it don't. But at the same time, if I do, I run the risk of treatment that might be ultimately detrimental.

Those of you who have made the decision to get the screening, what motivated you to do so? Do you wish you hadn't? Do you think the screening made any difference? What might have happened if you chose not to?

Thanks.



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My father's screening caught his very aggressive prostate cancer before it could kill him. Even though he had it removed, he still has a 50% chance of having it reoccur. It's worth the test.
I recommend this to everyone - go read the book Overtreated and then make the decision for yourself.

Topher is right - it's a screening test, though not a very good one. It produces a lot of false positives.

Screen, if you have it then assess the situation.  Some cancers are so slow as to not be a problem, some are not.  There is a concern about over treatment. 

Trust me on this.  You really need to keep the old body's systems checked.  It's analogous to checking the underhood fluids in your car.

Far, far better to discover that your enlarged prostate (yes, I am that old) is not due to an inoperable cancer.  The one you didn't get diagnosed because you didn't mind peeing half a dozen times a night.

You are wise (and fortunate to be able) to trust your personal physician, but the bottom line is that YOU are ultimately responsible for your health, not your doctor.  Sounds to me like he really cares about his patients.

Learn what the signs of prostate cancer are.  I'm not a doctor, and I don't put myself out there as one.  But 40 does appear to be too young.  Since your dad had it, you might be at increased risk, but your doctor is right: that doesn't mean you'll get it.  Still, know the signs.  Have anything suspicious checked out by a licensed physician.

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