NPCC President Richard Atkins
March 13, 2002
TO THE EDITOR:
Men don't need another excuse to avoid taking care of their health. Sadly, when it comes to early detection of prostate cancer (What's a Guy to Do - March 18), Science Editor Christine Gorman may have given them one.
Prostate cancer remains the most commonly diagnosed malignancy in American men and the second leading cause of male cancer death. Still, deaths from prostate cancer have decreased over 27 percent in the past five years, in part attributed to PSA screening. Disputing the conclusions Gorman reaches, a recent Austrian study shows that prostate cancer mortalities in one section of that country were markedly reduced after widespread PSA screening had begun.
While Gorman correctly notes that PSA is not a perfect screening tool, if it is abnormal, there are subsequent blood tests that can be performed to better determine possible cancerous conditions.
Prior to the PSA test, nearly three-out-of-four men diagnosed with prostate cancer were in the late stages of the disease - a point in which prostate cancer is neither readily treatable nor curable. That statistic has inverted since the advent of screening, giving men a fighting chance against the disease.
While we do need more research to offer a better prevention model, more than 400,000 men will die waiting up to 14 years for the results of randomized trials to determined the effectiveness of PSA (not five to 10 years as Gorman suggests).
With so many lives in the balance, how much evidence is necessary before it is realized that the risk of having prostate cancer far outweighs any risks attached to any testing procedure. The PAP smear has saved the lives of countless women since it was introduced - without any prior clinical trials to prove its efficacy. Men over the age of 50 (younger if African American, a veteran exposed to Agent Orange or one with a family history of prostate cancer) should resolve to get tested annually. Senator Bob Dole, former New York Mayor Rudy Giuliani, retired General H. Norman Schwarzkopf, Michael Milken and Major League Baseball managers Joe Torre and Dusty Baker - along with millions of men and family members whose lives have been touched by this devastating disease - would agree.
Richard N. Atkins, M.D.