Yesterday’s announcement that men should not get routine PSA tests to check for hidden prostate cancer is sure to spark controversy for months to come. But the U.S. Preventive Services Task Force (USPSTF) made the right decision. On the surface, rejecting the use of a simple blood test that can detect cancer in its early and still-treatable stage sounds foolish. Cynics have been saying it is the handiwork of a group concerned more about health-care rationing and cutting costs than about health. The decision is wise, not foolish, and will improve men’s health, not harm it. The word “cancer” usually brings to mind images of a fast-growing cluster of cells that, without aggressive treatment, will invade other parts of the body, damage health, and potentially kill. That certainly describes many cancers. But not most prostate cancers. Most of the time, prostate cancer is sloth-like. It tends to grow slowly and remain confined to the prostate gland, with many men never knowing during their entire lives that a cancer was present. These slow-growing prostate cancers cause no symptoms and never threaten health or longevity. That means many men with prostate “cancer” never need treatment.
A simple blood test to check seemingly healthy men for hidden prostate cancer does more harm than good and shouldn’t be part of routine medical care. That’s the long-awaited final recommendation from the United States Preventive Services Task Force (USPSTF), published today in Annals of Internal Medicine. About half of men over age 40 get this test as part of a regular checkup. It measures the amount of a protein called prostate-specific antigen, or PSA, in the bloodstream. An above-normal PSA level can signal hidden prostate cancer. But it can also be a sign of prostate infection, an enlarged prostate, and other problems. Hunting for hidden disease in the absence of any outward signs or symptoms is called screening. The task force says that for every 1,000 men who have routine PSA tests, 0 to 1 deaths from prostate cancer will be prevented. But that is offset by 3 serious cardiovascular deaths due to treatment, along with 47 men who will live with treatment-related erectile dysfunction or incontinence.
In an effort to stem the smoldering epidemic of hepatitis C, the Centers for Disease Control and Prevention is proposing today that all Baby Boomers—anyone born between 1945 and 1965—have a one-time test for hepatitis C. This widespread but often silent disease can lead to liver damage, and even death.
An experimental approach to virtual colonoscopy could eliminate the unpleasant day-before bowel prep that keeps many people from having this potentially life-saving test. Virtual colonoscopy uses computed tomography (CT) scanning with X-rays, instead of a scope, to check the colon for cancers and precancerous polyps. Earlier version have required bowel cleaning, just like regular colonoscopy. A Harvard-based team led by Dr. Michael Zalis uses sophisticated computer software to make stool in the colon disappear. It’s a little like Photoshopping blemishes from still photos. “Laxative-free CT colonography has the potential to reach some of the unscreened population and save lives,” says Dr. Zalis, an associate professor of radiology at MGH and director of CT colonography at MGH Imaging.
Surviving cancer was once a challenging achievement. Today, more than 12 million Americans are cancer survivors, and many live long after their diagnoses. New guidelines from the American Cancer Society (ACS) offer them science-based advice for eating better and staying active—two keys to healthy living for cancer survivors and everyone else. The report, called Nutrition and Physical Activity Guidelines for Cancer Survivors, is available for free from the ACS website. The guidelines provide specific advice for survivors of a variety of major cancers: prostate, colorectal, lung, breast, ovarian, endometrial, upper GI, head and neck, and hematologic. They urge cancer survivors to maintain a healthy weight, avoid inactivity and return to normal daily activities as soon as possible following diagnosis, eventually aim to exercise at least 150 minutes per week, and follow an eating pattern that is rich in vegetables, fruits, and whole grains.
Warren Buffett may be the second richest man in America, but he appears to be getting the poorest medical advice. Buffett announced to Berkshire Hathaway shareholders last week that he has early stage prostate cancer that “is not remotely life-threatening or even debilitating in any meaningful way.” If Buffett’s cancer had been detected because he […]
A trio of new studies from the University of Oxford suggests that aspirin is worth testing as a simple way to help prevent cancer. But these are preliminary findings, and you shouldn’t start taking an aspirin a day without having a conversion with your doctor. That’s because aspirin has side effects that could offset any possible cancer-fighting benefit, including stomach upset, gastrointestinal bleeding and hemorrhagic stroke (bleeding in the brain). The Oxford studies couldn’t determine cause and effect. The only way to tally up the true balance of benefits and risks of aspirin for cancer prevention is with trials specifically designed to do that. Several are underway or in the planning stages. But you can work to prevent cancer right now by avoiding tobacco in all its forms, exercising, and making other healthy changes.
Many people have trouble quitting smoking even after learning they have cancer, according to a new study from Harvard-affiliated Massachusetts General Hospital. Five months after learning they had cancer, just over one-third (37%) of smokers diagnosed with lung cancer and two-thirds (66%) of those with colorectal cancer were still smoking. The results underscore how difficult it can be to quit smoking. A diagnosis of cancer can be a powerful motivator, but it isn’t always enough—extra help is often needed to quit. Kicking a smoking habit is good for health anytime. It is even more important after a diagnosis of cancer.
Many prostate cancers grow very slowly and never escape the prostate. They cause no symptoms, and never threaten health or life. Yet almost 90% of men told they have prostate cancer opt for immediate treatment with surgery or radiation therapy—which often cause trouble getting or keeping an erection and an assortment of urinary problems. Yesterday, a panel of experts convened by the National Institutes of Health recommended that many men with localized, low-risk prostate cancer be closely monitored, and that treatment be delayed until there was evidence that the disease was progressing.
The death of Kara Kennedy, the only daughter of the late Senator Edward M. Kennedy, at age 51 from an apparent heart attack while exercising offers a reminder of the possible long-term effects of cancer and its treatment. In 2002, Kennedy was diagnosed with lung cancer. After having part of her lung removed, she underwent chemotherapy and radiation therapy. She lived for another nine years, in apparently good health. One of the hazards of some cancer survivors face is that the treatments used to fight cancer—drugs, radiation, and hormones—sometimes damage the heart and arteries.