click on image to read article Here is the link to the NY Times article published last month.
Additional thoughts from Dr. Goldman:
Breast Cancer: In Europe, routine screening starts at the age of 50, is done every other year, but ends when the patient turns 65. Then mammograms are only done if the doctor or patient finds a mass or has other issues. Routine screening in patients with no symptoms is not performed.
Prostate Cancer: The chances that a man is carrying a quiet prostate cancer is about equal to his age. For instance, a 60-year-old man has a 60% chance that prostate cancer will be found (if enough biopsies are done). So it seems that an elevated PSA is mostly an excuse to perform a biopsy.
In 2014, about 210,000 men were treated for prostate cancer and about 30,000 died of the disease. For most of the last 30 years, the number of yearly deaths has remained at approximately 30,000 a year. During this time the number of men treated has grown from 30,000 annually to about 210,000. That is a lot of men treated with very little effect on the death rate. There are a lot of side effects from prostate cancer treatment. Thousands of men are becoming impotent, leaking urine or having their testosterone surgically or chemically eliminated with very little change in the death rate.
I heard a radio report in February stating that in 2016 half the men diagnosed with prostate cancer had decided not to receive any treatment. Here is my question: If you are going to refuse treatment, why get the biopsy? If you are going to refuse the biopsy, why get the PSA test?
The official United States Preventive Services Task Force says to start examinations at the age of 55 and to stop PSA testing when the male reaches 69. Was it even helping those men during the 14 years of exam recommendations? Many primary care doctors are still doing PSA tests on patients well into their 80s. Word of the new guidelines does not seem to be getting out.
Colorectal Cancer: Much better results. I agree with the guidelines.
Breast Cancer: In Europe, routine screening starts at the age of 50, is done every other year, but ends when the patient turns 65. Then mammograms are only done if the doctor or patient finds a mass or has other issues. Routine screening in patients with no symptoms is not performed.
Prostate Cancer: The chances that a man is carrying a quiet prostate cancer is about equal to his age. For instance, a 60-year-old man has a 60% chance that prostate cancer will be found (if enough biopsies are done). So it seems that an elevated PSA is mostly an excuse to perform a biopsy.
In 2014, about 210,000 men were treated for prostate cancer and about 30,000 died of the disease. For most of the last 30 years, the number of yearly deaths has remained at approximately 30,000 a year. During this time the number of men treated has grown from 30,000 annually to about 210,000. That is a lot of men treated with very little effect on the death rate. There are a lot of side effects from prostate cancer treatment. Thousands of men are becoming impotent, leaking urine or having their testosterone surgically or chemically eliminated with very little change in the death rate.
I heard a radio report in February stating that in 2016 half the men diagnosed with prostate cancer had decided not to receive any treatment. Here is my question: If you are going to refuse treatment, why get the biopsy? If you are going to refuse the biopsy, why get the PSA test?
The official United States Preventive Services Task Force says to start examinations at the age of 55 and to stop PSA testing when the male reaches 69. Was it even helping those men during the 14 years of exam recommendations? Many primary care doctors are still doing PSA tests on patients well into their 80s. Word of the new guidelines does not seem to be getting out.
Colorectal Cancer: Much better results. I agree with the guidelines.
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