Prostate cancer is present in 30% to 40% of men over the age of 50 years, but only one-quarter of these cancers become clinically evident.
What is the controversy?
There are two schools of thought about PSA testing for prostate cancer. Advocates believe that the large number of patients who die of the disease warrants screening programs, arguing that lives can be saved by early detection and treatment.
Screening is most likely to benefit patients who have at least 10 years of life expectancy.
Critics of prostate cancer screening argue that the associated complications and costs are not sufficient to justify widespread implementation of aggressive screening programs. Furthermore, there is over detection of harmless tumours.
Seventy to 80% of Australians are cured of their cancer with surgery or good radiotherapy, unfortunately, that leaves 20 to 30% who will get a reoccurrence of PSA or prostate cancer.
When the PSA goes up quickly, that is when it is doubling faster than every three months, we often place patients on hormone therapy to delay any secondaries from occurring and to prolong life.
For more information on PSA, download 'Prostate Cancer for the General Practioner'.