Should I Be Screened for Prostate Cancer?
- Oscar-winning actor and four-time Academy Award nominee William Hurt passed away Sunday after a hard-fought battle with prostate cancer. He was 71 years old.
- Since prostate cancer can behave differently from one man to another, there’s serious debate among doctors about when and if to screen for prostate cancer.
- The United States Preventive Services Task Force recommends that for men ages 55 to 69, the decision to undergo PSA-based screening for prostate cancer is a personal one and should be made in consultation with a doctor.
- There are no screening recommendations for men younger than 55. And the task force recommends against PSA testing for men aged 70 and older.
- However, if you have a close relative who has had prostate cancer, the risk that you will develop prostate cancer in your lifetime is almost double, so SurvivorNet experts recommend getting screened with a PSA test, sometimes as early as age 45.
His son, Alexander Hurt, confirmed that his father’s death was due to complications of prostate cancer. William Hurt died at his home in Portland, Ore.Read More
It was announced in May 2018, when William Hurt was 68 years old, that the actor had been diagnosed with advanced-stage prostate cancer that had spread to his bones.
Understanding Prostate Cancer, the Disease that Claimed William Hurt
Prostate cancer is the most common form of cancer in men. It starts in the walnut-shaped prostate gland, which is located between the rectum and bladder and produces the fluid that nourishes sperm.
In the United States, most prostate cancer is caught with screening examinations. However, prostate cancer can behave differently from one man to another, and because of this, there’s serious debate among the top doctors and medical societies in the U.S. when it comes to screening for prostate cancer. (But more on that in the next section.)
Sometimes, the disease is called “low-risk” and can be slow-growing; treatment might not be necessary in these cases. But in other men, the cancer may grow faster or be more aggressive and will require treatment. (It remains unclear whether William Hurt’s cancer was slow-growing but caught late, or if he had a more aggressive form of the disease that resulted in his death.)
Because this cancer can behave so differently from one person to the next, screening and treatment decisions are individualized for each person. For men diagnosed with advanced-stage disease, like Hurt, there are many new treatment options available to you that will allow you to maintain an excellent quality of life.
Should I Be Screened for Prostate Cancer?
As previously mentioned, since prostate cancer can behave differently from one man to another, there’s serious debate among doctors about when and if to screen for prostate cancer.
The United States Preventive Services Task Force is an independent panel of experts that reviews the effectiveness and develops recommendations for clinical preventive services. This group recommends that for men ages 55 to 69, the decision to undergo periodic PSA-based (prostate-specific antigen) screening for prostate cancer is a personal one and should be made in consultation with a doctor. It should be noted that William Hurt was 68 years old when it was announced that he had prostate cancer, so he was within the recommended age bracket for screening.
There are no screening recommendations for men younger than 55. And the task force recommends against PSA testing for men aged 70 and older.
The task force states its recommendation is based on the fact that many men will experience potential harm from screening using the PSA-based test.
Dr. Jim Hu, a urologic oncologist at Weill Cornell Medicine, reiterated this point in a previous interview with SurvivorNet: “There are harms of PSA testing, because you may over-diagnose, or you may find prostate cancers in men who were more likely to die of something else, or that you would subject these men to biopsies which are uncomfortable, and have about a 2 percent to 3 percent risk of a serious infection.”
However, despite this fact, if you have a close relative who has had prostate cancer, such as a brother or father, the risk that you will develop prostate cancer in your lifetime is almost double. Men with a family history tend to get prostate cancer at a younger age, so SurvivorNet experts recommend getting screened — in some cases, as early as age 45 — with a PSA test.
There Are Problems, But the PSA Test is Not All Bad
“The problem with PSA testing is that it’s not totally specific for prostate cancer,” Dr. James Brooks, a urologic oncologist at Stanford Medicine, previously told SurvivorNet. “It can also reflect enlargement of the prostate, which most men get at some point in their lifetime.”
The point is that the PSA test is not a perfect test, according to Dr. Edwin Posadas, director of the Translational Oncology Program at Cedars-Sinai Medical Center in Los Angeles.
The PSA test is more controversial when it comes to using it to detect prostate cancer in older men. This is because most men will develop prostate cancer at some point in their lives if they live long enough, Dr. Geoffrey Sonn, assistant professor of urology at Stanford Medicine, previously told SurvivorNet.
But most men will not die from prostate cancer. Unfortunately, William Hurt was not one of those men. So, it is important to note that while most of the time, prostate cancer is slow-growing and won’t kill you, there are cases where the disease can be fatal.
The point is that the PSA test is not all bad. Experts agree that some valuable information can be gained from it. But its role in detecting prostate cancer remains a highly debated topic. If you think this test is right for you, talk to your doctor.
Contributing: SurvivorNet staff reports