Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

USPSTF prostate cancer screening guidelines need emotion to resonate

Kevin Pho, MD
KevinMD
October 7, 2011
Share
Tweet
Share

Prostate cancer screening has always been controversial.

Now, with the USPSTF is recommending against screening for prostate cancer, gas is about to be poured on the proverbial fire.

Recently, the New York Times Magazine published a lengthy piece on the issue, perhaps not coincidentally, perfectly timed with the Task Force’s announcement.

In 2009, advocates for breast cancer screening were up in arms, with the Task Force recommending that mammograms for women between the ages of 40 and 49 were optional, and decision individually made between patients and providers.

This time, the recommendation against prostate cancer screening is more forceful, and is bound to not only be politicized, but attacked by specialists and prostate cancer survivors.

Prostate cancer screening is most commonly performed by a blood test testing for the prostate specific antigen, or PSA. But the test is not without its risks:

From 1986 through 2005, one million men received surgery, radiation therapy or both who would not have been treated without a P.S.A. test, according to the task force. Among them, at least 5,000 died soon after surgery and 10,000 to 70,000 suffered serious complications. Half had persistent blood in their semen, and 200,000 to 300,000 suffered impotence, incontinence or both. As a result of these complications, the man who developed the test, Dr. Richard J. Ablin, has called its widespread use a “public health disaster.”

I wrote in the New York Times earlier this year that Medicare should stop paying for PSA screening in men over the age of 75, mainly because PSA isn’t good enough to detect which prostate cancers are dangerous, or not.  There is no conclusive data showing PSA saves lives.

But statistics don’t resonate. In fact, prostate cancer screening supporters are already lining up in force to tell their inspiring stories of prostate cancer survival:

Advocates for those with prostate cancer promised to fight the recommendation. Baseball’s Joe Torre, the financier Michael Milken and Rudolph W. Giuliani, the former New York City mayor, are among tens of thousands of men who believe a P.S.A. test saved their lives.

To combat this, Task Force advocates will need to put a human face on the complications stemming from prostate cancer. Something like this:

[National Cancer Institute researcher Otis] Brawley tells the story of a patient who had surgery and then underwent radiation, which left him with severe damage to both his rectum and ureter. “He had every side effect known to man,” Brawley says. “He had a bag for urine, a bag for stool, he was a terrible mess, in and out of the hospital with infections.” The man died six years after his surgery, from an overwhelming infection. Yet cancer statistics would list such a man as a success story, Brawley says, “because he survived past the five-year mark.” Would an untreated prostate cancer have killed him within six years, too? There is simply no way to know.

Politicians and celebrities will use their poignant stories to powerfully attack the recommendations.  Evidence-based supporters will need more than cold terms like “number needed to treat” and “absolute risk reduction.”

ADVERTISEMENT

Without stories of their own, the Task Force recommendations will be vilified in the arena of public opinion, despite having the studies on their side.  In today’s health care environment, emotion trumps data.

Kevin Pho is an internal medicine physician and on the Board of Contributors at USA Today.  He is founder and editor of KevinMD.com, also on Facebook, Twitter, Google+, and LinkedIn.

Prev

5 ways to cut breast cancer risk

October 7, 2011 Kevin 4
…
Next

Palliative care physicians can enhance patient decision making

October 7, 2011 Kevin 2
…

Tagged as: Oncology/Hematology, Patients, Primary Care, Specialist

Post navigation

< Previous Post
5 ways to cut breast cancer risk
Next Post >
Palliative care physicians can enhance patient decision making

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Kevin Pho, MD

  • Surgeon General’s warning: the dark side of social media on children’s mental health

    Kevin Pho, MD
  • Unmasking wage disparity in health care: the truth behind the Elmhurst Hospital physician strike

    Kevin Pho, MD
  • Is FDA-approved Veozah a game-changer in menopause hot flash treatment?

    Kevin Pho, MD

More in KevinMD

  • The Spandex dilemma: Does size still matter?

    Janet L. Cray
  • Surgeon General’s warning: the dark side of social media on children’s mental health

    Kevin Pho, MD
  • Unmasking wage disparity in health care: the truth behind the Elmhurst Hospital physician strike

    Kevin Pho, MD
  • Is FDA-approved Veozah a game-changer in menopause hot flash treatment?

    Kevin Pho, MD
  • Remembering Heather Armstrong: the tragic loss of the “Queen of Mommy Bloggers” sparks a global conversation on mental health

    Kevin Pho, MD
  • Celebrating 2 million downloads of The Podcast by KevinMD!

    Kevin Pho, MD
  • Most Popular

  • Past Week

    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
    • Physician patriots: the forgotten founders who lit the torch of liberty

      Muhamad Aly Rifai, MD | Physician
    • The hidden cost of becoming a doctor: a South Asian perspective

      Momeina Aslam | Education
    • Why fixing health care’s data quality is crucial for AI success [PODCAST]

      Jay Anders, MD | Podcast
    • Closing the gap in respiratory care: How robotics can expand access in underserved communities

      Evgeny Ignatov, MD, RRT | Tech
    • Reclaiming trust in online health advice [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
  • Recent Posts

    • Why fixing health care’s data quality is crucial for AI success [PODCAST]

      Jay Anders, MD | Podcast
    • Why so many physicians struggle to feel proud—even when they should

      Jessie Mahoney, MD | Physician
    • If I had to choose: Choosing the patient over the protocol

      Patrick Hudson, MD | Physician
    • How a TV drama exposed the hidden grief of doctors

      Lauren Weintraub, MD | Physician
    • Why adults need to rediscover the power of play

      Anthony Fleg, MD | Physician
    • How collaboration across medical disciplines and patient advocacy cured a rare disease [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 13 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
    • Physician patriots: the forgotten founders who lit the torch of liberty

      Muhamad Aly Rifai, MD | Physician
    • The hidden cost of becoming a doctor: a South Asian perspective

      Momeina Aslam | Education
    • Why fixing health care’s data quality is crucial for AI success [PODCAST]

      Jay Anders, MD | Podcast
    • Closing the gap in respiratory care: How robotics can expand access in underserved communities

      Evgeny Ignatov, MD, RRT | Tech
    • Reclaiming trust in online health advice [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
  • Recent Posts

    • Why fixing health care’s data quality is crucial for AI success [PODCAST]

      Jay Anders, MD | Podcast
    • Why so many physicians struggle to feel proud—even when they should

      Jessie Mahoney, MD | Physician
    • If I had to choose: Choosing the patient over the protocol

      Patrick Hudson, MD | Physician
    • How a TV drama exposed the hidden grief of doctors

      Lauren Weintraub, MD | Physician
    • Why adults need to rediscover the power of play

      Anthony Fleg, MD | Physician
    • How collaboration across medical disciplines and patient advocacy cured a rare disease [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

USPSTF prostate cancer screening guidelines need emotion to resonate
13 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...