I had an annual check up with a new physician who is associated with a teaching hospital. He told me that he would not do testing but he did not really explain why and this confused and angered me because prostate has run in my family and because I had always been told the opposite. I asked for a PSA test anyway and he still did not run the test. Then, I called and went back in and had the test administered. Results indicate no danger. It is only because I saw a short piece in the AARP journal that referenced the discussion that I went back to the internet and did a little research. So now I see that my MD was acting on a good basis. But I think that his problem was that he did not really explain to me the issues and why the new guidelines are there. And I was so surprised by the discussion, that I was unprepared to ask good questions.
Dan Hoffmanof IN9:58AM April 28, 2012
Routine PSA screening for elderly men in the United States continuous to be prevalent for three main reasons:
1) Fear of litigation by men who develop advanced prostate cancer
2) Not enough time for the physician to thoroughly discuss the risks and benefits of PSA screening with elderly men. Unfortunately, it is much quicker and easier to order a blood test then to have a 15 minute discussion about why most elderly men in their late seventies and 80s do not need PSA screening.
3) Strong patient desire. As a Urologist, I see men in their 90s come to my office requesting to have routine PSA tests done. While I counsel these patients against the test, some are adamant in their desire to know their PSA scores.
These combination of factors leads to almost half of men in their late 70s and 80s undergoing PSA testing while the testing may benefit only a tiny minority of them. The answer to this problem is, unfortunately, not easy. It requires physicians to take the time to evaluate every patient individually for the need for a PSA test. This determination should not be made solely on age but on overall health and life expectancy. It also requires doctors to then take the time to counsel each patient on the risks and benefits. Only through education can these unnecessary tests and subsequent treatments be avoided.
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Dan Hoffman of IN 9:58AM April 28, 2012
Prostate Doc of CA 12:35AM April 25, 2012