Thursday, February 26, 2009

Prostate Cancer, Finasteride, Prevention, PSA

What is a man to do? The confusing world of prostate cancer screening and treatment just got more confusing. New joint guidelines produced by the American Society of Clinical Oncology and the American Urological Association has recommended a certain medication (finasteride) for the prevention of prostate cancer in healthy asymptomatic men. Why is this confusing? Isn't prevention a good thing? I want to talk a bit about prostate cancer and the conundrums associated with it.

There are some things that we do know. Prostate cancer is the second leading cause of cancer death in men after lung cancer. It occupies the same place as breast cancer does in women. More people die of colorectal cancer than either prostate or breast cancer but that is referring to men and women together. Approximately 186,000 men in the United States are diagnosed with prostate cancer each year and in that year approximately 30, 000 men will die of it. Prostate cancer dispropotionally affects black men more that whites or other ethnic groups. Prostate cancer is a disease of middle aged to old men usually first diagnosed in those over 50 years old although there a a number of cases in men in their 40's, again dispropotionally more often in black men. Prostate cancer does have a genetic component sometimes but most of the time the causes are unknown. Prostate cancer is curable either by surgery or radiation in the early stages but once locally advanced beyond the wall of the prostate gland is universally fatal as there is no effective chemotherapy. There are treatments, but they are only palliative, not curable

A recommendation for preventive chemotherapy then is big news. But there is till controversy about screening for prostate cancer. The American Urological Association (AUA) has now recommended this preventive treatment but this recommendation comes with a caveat. It is only for those men who have been screened by a blood test for prostate - specific - antigen (PSA) which is a tumor marker and is used for detecting and diagnosing prostate cancer. The new guidelines are for men whose PSA value is 3.0ng/ml or lower. Yet the American Urological Association has not come out with a clear recommendation for men to be screened in the first place! No major cancer group or physician group has come out and actually made a recommendation for routine prostate cancer screening and like the others the AUA is still sitting on the fence despite the high numbers of prostate cancer deaths per year. Confusing?
I will explain more tomorrow.

Thought for the day

"One prostate cancer death per year is one death too many".

The National Prostate Cancer Coalition

No comments:

Post a Comment

Thank You For Your Comment!

CARF - Commission on Accreditation of Rehabilitation FacilitiesNATSAP | National Association of Therapeutic Schools and ProgramsNBCCNAADAC