Local Prostate Cancer Support Group may hold the answers

By Letter to the Editor on May 22, 2019.

Re: “What’s Up Doc?: Is the prostate-specific antigen test a public health disaster?,”April 30

The recent column refuting the value of routine annual PSA screening of men was disturbing.

Prostate cancer screening is one of the most controversial issues in urology and preventative medicine. With varying recommendations on PSA screening, no consensus is established among several professional and government organizations. Many professional associations, including the American Urological Association, the National Comprehensive Cancer Network, the European Association of Urology, and the American College of Physicians recommend offering PSA screening to interested men after a thorough discussion of the benefits and harms. When prostate cancer screening is performed, the overarching goal should be the early detection of clinically significant prostate cancer in healthy men while minimizing the detection and treatment of low-risk disease.

When it comes to the value of the PSA test perhaps the most relevant argument for the test is to look at our local Prostate Cancer Support Group here in Medicine Hat for answers.

The group has grown from four men four years ago to nearly 50 now and comprises of men in the 55 to 80-year age group. The men have all been diagnosed initially through digital examination and an elevated PSA, in some cases the PSA test confirmed the digital exam. Further testing through a biopsy of the prostate gland allowed for a grading of the cancer to determine treatment options. Many of the men in our group had no physical indication of prostate cancer, it was the PSA test with an elevated level of antigens that led to further investigation. The digital exam either confirmed the PSA test or was the reason for the PSA test; no one in our group received treatments without the results of the PSA test being known.

Had the PSA tests or digital exam not been performed, it is quite possible that without being identified, depending on its aggressiveness, the cancer would have escaped from the prostate capsule to spread to other parts of the body, and become very difficult to treat. Some men in our group are in the 60-year-old age group where the cancer often shows a quicker doubling time with more aggressiveness.

Many men in our group have had a positive prostate cancer diagnoses and are on “Watchful Waiting” regimen. This means that through three-month PSA tests the levels are monitored closely and the cancer growth speed carefully monitored before further treatments are conducted.

The Canadian Urological Association advises that “Population-based screening has demonstrated benefits in reducing prostate cancer mortality.” Prostate Cancer is currently the number three cause of cancer related deaths among men in Canada.

Philip Buisseret

Redcliff

(The writer is chairman, Medicine Hat and Area Prostate Cancer Support Group)