Time and time again, people question the value of the PSA, but it remains the first line-screening tool for prostate cancer. Despite concerns the test is not always a reliable indicator and may have little value for older men.
“You’ll hear people say, ‘I don’t need to check this because I’m going to die of something else before I die of prostate cancer.’ If you take that old philosophy, what do you do with all these guys now that are making it to the age of 90,” says Dr. Jasper Rizzo, urologist on Lee Memorial Health System’s medical staff.
Results of a large study followed thousands of men 65 and older who had PSAs beyond the normal range. Watching them for five years, only 33% underwent a biopsy, 63% of those biopsied had cancer and 82% of them went on to treatment.
“Prostate cancer is not a death sentence, but the earlier you treat it in any age groups, the earlier you pick it up, the better chance you have of either A: curing or B: slowing it down,” says Dr. Rizzo.
Age becomes an issue because many times prostate cancer involves slow-growing tumors that in older patients may never lead to serious illness or death, but may lead to unnecessary treatment.
Laure Wise is a nurse navigator who helps men newly diagnosed with prostate cancer.
“What I usually tell patients is that everybody’s different. For some patients with prostate cancer, it can be very slow growing. And those patients it is certainly appropriate to do the watchful waiting,” says Laure Wise, prostate cancer navigator on Lee Memorial Health System’s medical staff.
Watchful waiting means to monitor disease progression and respond as needed. With more men being diagnosed and more men living longer, it will only lead to more conversations.
“The recent controversy over the screening has really benefited patients because what it does is stimulates them to go to their physician,” says Wise.
And make an educated choice.