BACK TO: DIAGNOSIS: PSA:
CANCER SCREENING CONSENT
draft was drawn up by Dr Gerald Chodak who has spent many years working on providing
good balanced information to prostate cancer men. He was authored a book entitled
Battle Against Prostate Cancer Get The Treatment That's Right For You which
was published in December 2010. You can go along to Vook
and buy Prostate
Cancer: Reducing Your Risks a publication written and produced by Dr Gerald
Chodak or you can visit his informative site loaded with videos at Prostate
Videos Dr Chodak also also has a FaceBook site - Prostate
Cancer Education and was one of the people who set up US-TOO, the well known
Currently, doctors have varying
opinions about whether you should or should not get screened for prostate cancer.
Everyone agrees that testing and eventual treatment has both risks and benefits.
The aim of this document is to provide you with enough information so that you
can help your doctor decide if the tests should be done on you. Any questions
you have can be answered when you see the doctor.
Facts About Prostate
It is the most common type of cancer in men and the second most common cause of
death from cancer.
chances of having prostate cancer increase with age; 30% of all men have it at
age 50 and almost all men have it by age 80.
men and those with a father or brother with prostate cancer have a higher chance
of having this disease than other men.
3 out of 100 over age 50 will eventually die from prostate cancer, which means
that most men who have it will not be harmed by it even if it is never diagnosed
Doctors cannot be sure which prostate cancers are potentially harmful and definitely
need treatment and which ones can be observed without immediate treatment.
about Screening for Prostate Cancer
The goal of screening is to reduce your chances of being harmed or dying from
Two tests are used to screen for prostate cancer beginning at age 50, the PSA
and the DRE.
o The PSA measures a protein called Prostate Specific Antigen.
It is produced by both normal and cancer cells. A PSA value cannot determine if
you do or do not have prostate cancer but the higher the number, the greater the
chance that cancer is present.
o The DRE, or digital rectal exam involves
the doctor inserting a gloved, lubricated finger into the rectum to check for
anything that feels abnormal.
If either the PSA or DRE is abnormal, a doctor would need to do a prostate biopsy
to find out if cancer is present.
About 15 out of every 100 men will be told to have one based on their test results.
Prostate Cancer will be detected in about 1 out of every 4 men who has a biopsy,
which means 3 out of every 4 men without cancer will have an unnecessary biopsy.
biopsy can cause pain or other side effects and in some cases must be repeated
one or more times.
The odds of benefitting from screening are extremely low unless you are likely
to live at least ten more years.
For every 1000 men between the ages of 55-69 that are screened over ten years:
One man will be prevented from dying of the disease.
o About 25 men will need
to be treated.
o Approximately 8 to 10 suffering impaired erections or urinary
incontinence or both
o 2 will suffer a heart attack or other heart problem
1 will develop a serious blood clot due to their treatment.
o Other complications
will develop in some men depending on which treatment they receive.
You Should Have the Screening Tests (The PROS):
expect to live longer than 10 years and want to minimize being harmed from prostate
cancer during that time.
cancer is much easier to cure if it is detected in an early stage and before any
cancer cells spread to other parts of the body.
If you have prostate cancer and it isn't detected until it spreads to other parts
of your body, you may suffer pain, require multiple treatments and your life may
The PSA and DRE are the best ways to find early stage disease and minimize the
chances that prostate cancer will harm you.
Why You Should NOT have
the Screening Tests (The CONS):
men who have prostate cancer that is detected by screening are no better off than
if they were not screened. The reason is that most of them are slow growing, would
never cause any harm and most men die from something other than prostate cancer.
men diagnosed by screening will undergo a treatment they did not need because
their cancer is not life threatening.
You are more concerned about maximizing your quality of life rather than how long
HOW TO MAKE YOUR DECISION
SHOULD get the screening tests if you think that:
The small chance of lowering your risk of suffering from prostate cancer is sufficient
o You can live with the potential chances of developing side effects from
biopsy and treatment that may reduce your quality of life.
You SHOULD NOT get the screening tests if you think that:
The odds of benefitting are too low to justify the potential harms of treatment
o You are more concerned about preserving your quality of life.
____Yes, I want the tests at this time.
____ No, I do
not want the tests at this time.
____ I want the doctor to decide for me.
a well balanced presentation on this issue, go along to The