Jefferson University Hospitals

According to the Prostate Cancer Foundation, prostate cancer is the most common non-skin cancer in America – affecting one in six men. This year, more than 192,000 men will be diagnosed with prostate cancer, and more than 27,000 men will die from the disease.

The most common way to screen for prostate cancer is a blood test that measures prostate specific antigen (PSA). Because various factors can lead to elevated PSA levels, a biopsy must be performed to confirm a tumor.

Two studies published this spring in the New England Journal of Medicine suggest that screening for prostate cancer doesn’t necessarily save lives – and that any benefits of screening can come at a high price.

The studies – one in the United States and the other in Europe – reached different conclusions.

In the U.S., where screening is widely used, researchers reported that it did not save lives in a study of 76,000 men. In Europe, where PSA screening isn’t a routine practice, researchers studied 162,000 men and found a slight reduction of about seven fewer deaths per 10,000 men screened. However, screening subjected men to the risk of getting treatments they didn’t need – and experiencing serious side effects, such as impotence and incontinence.

What Does it Mean for You?
When the studies were released, local TV news stations turned to Leonard Gomella, MD, chair of the Department of Urology at Thomas Jefferson University Hospital.

In his remarks, Dr. Gomella reminded patients that one of the studies is still in progress, so it’s too soon to determine if its results are conclusive.

“Studies such as these send a mixed message to patients. Some may say, ‘Do not worry about prostate cancer,’ but the fact is that this is the leading solid tumor in men and the second-leading cancer killer – facts that are difficult to ignore,” Dr. Gomella noted.

He said these studies do suggest that the approach to many tumors may not need to be as aggressive as previously thought.

“The concept known as ‘watchful waiting’ or ‘active surveillance’ – where the patient is followed and treated only if the cancer begins to become a risk factor – is becoming more accepted,” he explained.

The bottom line: There is no way to predict which tumors are likely to require surgery, radiation or drugs versus which are not. Dr. Gomella urged men to work with their physicians, keeping in mind that prostate cancer “is not a ‘toothless tiger.’”

For more information about prostate cancer care at Jefferson, visit the Department of Urology website. Make an appointment with a Jefferson physician online or by calling 1-800-JEFF-NOW.