Do we need screening tests for prostate cancer?

Recently, actor Ben Stiller claimed to have prostate cancer. This is a pretty scary disease for men, but it is not a hope. As in Stiller's case, thanks to timely detection of the disease, it offers an opportunity to effectively treat treatment regimens from an early stage. So should we go for routine testing? In fact, it is still a controversial issue in the scientific world.

PSA tests really diagnose cancer

In a recent interview, Ben Stiller revealed for the first time that he had suffered prostate cancer two years ago. At 50 years of age, Stiller said the conclusion was given by doctors after giving him a prostate-specific antigen test (also called a PSA test) . In particular, abnormally high levels of PSA in the blood are one of the signs that the man may have prostate cancer. In Stiller's case, he was then given MRI and biopsy to confirm that he had cancer.

However, Stiller said: "These tests saved my life." Why can Stiller be optimistic about such cancer? Basically, PSA is one of the main tests in prostate cancer screening. However, this is still a controversial issue in the medical world.

Actor Ben Stiller.

The question is still controversial

In 2012, the US Agency for Preventive Services (USPSTF - a panel of advisors to the federal government) recommended that men do not need to conduct screening for prostate cancer. periodically at any age.

In contrast, the American Cancer Society recommends that men in their 50s seek medical advice to conduct prostate cancer screening tests if they are at risk of moderate or Do this around 40 - 45 years if someone in the family has it. The biggest problem in prostate cancer screening procedures is that PSA testing may help identify the disease early, but it is not clear whether the benefit of the test is greater than the long-term risks for most men or not.

According to the USPSTF, a problem with the PSA test is that it usually results in prostate cancer positive despite the fact that the person is not sick. Statistics show that about 75% of men have abnormally high PSA levels but do not have cancer. This is a false positive situation but leads to unnecessary worries and fears after testing. On the other hand, PSA is not always able to detect cancer. About 20% of men have prostate cancer but have normal PSA levels, so wrong test results can lead to subjective psychology in patients.

Moreover, even if prostate cancer is found, the doctor cannot guarantee whether it is really a threat to the health of the male patient. In many cases, prostate cancer does not develop or cause symptoms, or it develops so slowly that it is impossible to cause any problems to the patient's health for a lifetime. The American Cancer Society also said: "Based on high PSA levels, some male patients may be diagnosed with prostate cancer, but they may not even understand it. The disease may not be. now dangerous to their lives or even cause any symptoms ".

This means that some men with prostate cancer may receive treatments that they really do not need. And treatments like surgery or radiotherapy are of course not gentle at all. More seriously, these measures can also lead to impairment of erectile dysfunction, incontinence and problems with intestinal activity control. In fact, Stiller shared in an interview that he was suffering from some side effects during treatment and revealed that sex life had many changes after surgery.

Stiller revealed that sex life has changed a lot after surgery.

Stiller said: "It takes time to get back to normal. It has changed my experiences of feeling orgasm. It is wonderful and just has a different feeling." In general, it is unclear whether early detection of prostate cancer reduces the risk of death from patients due to the disease. A study in 2012 based on 76,000 men found that there was no difference in the mortality rate due to illness among those who conducted the annual screening and those who only tested when they had advice. Doctor. In other words, research suggests that screening for prostate cancer every year is not necessary for most men.

Options when diagnosed are prostate cancer

Many experts believe that a procedure called proactive monitoring can reduce unnecessary medical treatments. Under active surveillance, patients diagnosed with a low risk of prostate cancer will regularly monitor the test and only treat it when the cancer progresses to a bad level.

So far, a recent study found that men with prostate cancer will at least live for more than 10 years regardless of whether they are actively monitored, surgery or radiation therapy. However, the study also found that patients who used proactive follow-up after diagnosis of cancer had a higher risk of progression and metastasis than patients treated with surgery or radiotherapy. At the same time, about half of the patients initially chose to be actively monitored but ended with surgery or radiotherapy.

The study was published Sept. 14 in The New England Journal of Medicine and in that, scientists concluded that they needed to follow the subjects for longer to draw conclusions. final. They hope that follow-up will provide more information to identify patients who choose to actively monitor the difference in cancer mortality compared to patients who choose another option.