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PSA test for prostate cancer

According to the National Cancer Institute's Annual Report 2018 to the nation on the status of cancer in recent years, cases of prostate cancer (PCa) have increased slightly in recent years, after decades of steady decline. In response, the United States Preventive Task Force changed its long-term recommendation against PSA screening in May 2018. The new advice: Men 55-69 should discuss the pros and cons with their doctor and decide for themselves whether screening makes sense.

Why not? While the USPSTF acknowledges that PSA testing may offer a potential benefit to a small number of men at this age, it quickly adds that many men "may suffer potential screening damage, including false-positives, the additional ones Testing may require and possible prostate biopsy; about diagnosis and over-treatment; and treatment complications such as incontinence and erectile dysfunction. "

For legions of" well-cared "fellows ̵

1; longtime True Believers in mantra – catch it early, heal it up – the ambiguous USPSTF advice is re-creating a moral dilemma. If you do not choose for a screening, as several experts still recommend, are you just a cowardly ostrich?

"We have been taught to believe that it is virtuous to act in the face of risks to our health," says biomedical ethicist Arthur Caplan, Ph.D., from NYU's Langone Medical Center. "It turns out, however, that this is not always the case, especially if the action you perform, such as PSA screening, does not work very well. Sometimes it is more virtuous to do nothing. "

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Unfortunately, nothing surprising can be difficult, especially for those who want to keep control of their fate Tips on how to make peace with your unshielded prostate.

Weigh the odds. Full statistics will be available in 2016. About 1,400,232 American men died, just under 30,000 of them PCa died, and half of them were in their 80s or older, in other words, their chances of never dying on PCa are nearly 98 percent – and even very late in life.

You know the PSA test [19659011]'s limitations. Even the best results data selected from the cherry plant suggest few asymptomatic symptoms. Men are likely to be rescued by PSA screening, but the few g Rescued lives seem to be balanced by other causes of death. As the meta-analysis of 2018 in BMJ stated despite the small absolute advantage of PCa mortality over 10 years, the PSA study does not improve the total mortality . "You should not be impressed by the illusion that the test is good," says Caplan, "or that the often-unnecessary treatment he triggers does not pose a great risk of side effects."

Put family history in perspective. "PCa is so easy to find that you can find it when you're looking for it," explains Mary McNaughton-Collins, MD, MPH, medical director of the Boston-based Informed Medical Decisions Foundation. "Because of the PSA screening, all these people tell us," I have a family history of the disease – my dad had it, my brother had it. "But you know, if we keep doing PSA testing, more and more men will have relatives who've been diagnosed, and having a family history of cancer in and of itself can be nerve-wracking." The task force, adds she advises most men from PCa screening regardless of their family history .

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			<span class= Getty Images KEVIN CURTIS

Large C, little approx. Many of us still believe that if he is not stopped early, cancer will be a relentless reaper to anyone unhappy enough to get him. "But it turns out," says Caplan, "that we all have cancer cells all the time, the our body is constantly fighting. Cancer is a minor chronic disease that only occasionally becomes a serious problem. Usually it's not the "Big C" we're all scared of, where you get it from and you're gone. "Much more often it's the & # 39; C strain & # 39; – abnormal cells that change so slowly survive them. "For most men," says Caplan, "PCa is the poster child for this slow-growing form."

Develop a healthy skepticism. Harvard psychiatrist Arthur Barsky, MD, has studied how various stakeholders of the "Medical Industrial Complex" thrive on raising our fears. "Every producer," he wrote in an influential editorial of the New England Journal of Medicine "tries to convince the public that something is dangerously wrong or is about to do something and that steps immediately must be remedied. "Do not be ridiculed.

Be open minded to another diagnosis. For some extremely risk-averse men, the fear of dying from PCa can be overwhelming. If this describes you, discuss your concerns with a trusted doctor. What's really worrying, you may have less to do with future PCa than with the current Generalized Anxiety Disorder (GAD), a treatable condition characterized by runaway health, family and / or financial fears.

Consider as an Alternative If you are still not convinced, ask your doctor for two new tests, phi and PCA3, both of which represent incremental improvements to the PSA test. None of these procedures has been approved by the FDA for PCa screening and insurers are unlikely to use the information. However, if you're willing to pay hundreds of dollars out of pocket, your doctor may agree to try one on you. Do not expect definitive answers, just slightly less cloudy than those from the PSA.

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