Father's World -Cancer screening continued.

cancer screening continued...

Treatment usually results in a cure even with advanced disease, but early detection of this cancer improves survival rates and allows for simpler treatment, often sparing the need for chemotherapy.

Prostate cancer is much more common than testicular cancer. And screening for prostate cancer is very complicated and has recently become very controversial. Approximately 300,000 cases are diagnosed each year, mostly in men over 60, and currently 40,000 people die each year as a result of it. African-Americans are more likely to develop the disease and more likely to be diagnosed at advanced stages than Caucasians; it is less common in Asians. There are several reasons why screening for prostate cancer is fraught with frustration.

First, asymptomatic cancerous cells can be found in the prostates of nearly all men over 80; however, only a few of these men have prostate cancer. Second, the tests used to detect cancer are not very sensitive (many people with cancer will test negative), nor highly specific (a positive test result does not always indicate disease).

Third, there has been no data yet that proves that early detection reduces mortality on a population basis. And fourth, the treatment of prostate cancer may have significant side effects-impotence, incontinence and decreased libido-making it hard to justify treatment that may not even reduce mortality.

The current screening tests for prostate cancer are generally covered by insurance. They involve two common procedures: a digital rectal examination (DRE) and a blood test for prostate specific antigen (PSA). Ultrasound studies can aid in diagnosis, but cost prevents it from being used as a screening test. The problems? The DRE can miss 10 percent to 15 percent of tumors, and the PSA is positive in up to 30 percent of people without prostate cancer. There will probably be new tests available soon that can better detect cancerous prostate cells. But most cancerous prostate cells do not go on to develop malignant prostate cancer. And we do not yet have the technology to predict who will develop the disease. And, again, we still do not have proof that early treatment aids in survival. Nevertheless, at this time, it is recommended that men over the age of 40 who have a family history of prostate cancer be screened with DRE and PSA every two years. Also, all African-American males over the age of 40 may have enough risk to consider screening. In any case, it is important that you discuss these tests with your doctor.