Prostate cancer. Cancer screening
Prostate cancer. The American Cancer Society, which is, by the way, in the business of finding cancer, it has a bias that way – recommends annual screening beginning at the age of 50 for all men. Screening should include digital rectal examination and prostate specific antigen testing. Screening should begin at the age of 40 if you are taking care of an African-American, or if you are taking care of a man who has a positive family history of prostate cancer. These are the recommendations by the U.S. Preventative Health Services task force; they also happen to be the recommendation by the American College of Physicians; that routine screening for prostate cancer with digital rectal exam, or serum tumor markers, or transrectal ultrasound is not recommended. Now, if screening is to be done … it’s interesting, the U.S. Preventative Health Services task force book says, it’s not indicated and there’s no data to support doing it. But if you are going to do it, here’s how you do it. If you are going to do it, use those tests, and you should limit the test to men who you expect to have a life expectancy of greater than 10 years. And at the moment, that means men up to the age of 74. Cheap levitra licensed pharmacy.
The burden here, is it causes 35,000 to 40,000 deaths per year. There is substantial morbidity from the disease. There is a very – for patients who die from this, it can be very painful. Like breast cancer. The problem is that autopsy studies show that there is latent prostate cancer in 9 million men who are autopsied, on a population basis. The prostate specific antigen is a pretty sensitive test, but it may detect patients where the prostate cancer is of uncertain clinical significance. In other words, it may just be there and may not cause the patient a problem. One of the good things about screening for breast cancer is that it is very clear that we should do something about it when we find it. When we find prostate cancer, then we have to decide, is it going to do any thing to this patient or not? Which is a more difficult issue. Canadian pharmacy viagra.
There is no evidence, yet, to determine whether early detection and treatment improves survival. All of the studies that have been done so far, mostly from Sweden and Norway, show that there is no difference in survival in men who undergo surgical procedures or other procedure for prostate cancer, and men who are watched and observed conservatively. For well and moderately differentiated disease, the treatment so far offers little benefit over expectant management. The improved survival for men with early stage disease, that we are beginning to see, may be due to the fact that we are making an earlier diagnosis and we are actually changing the natural history of the disease by observing them longer.