June Practice News

June is men's health month. Although women are the key health care decision makers in most families (sorry guys, but the data bears it out), men are taking a more proactive role in addressing their unique health issues. This is especially true in prostate cancer screening.

Prostate cancer is the 2nd most common cancer in men. The goal of screening via digital rectal exam (DRE) and/or prostate specific antigen (PSA) blood test, is to detect cancer at the early stage. Earlier detection and treatment should lead to reduced morbidity and mortality, at least that is the reasonable assumption.

Yet PSA screening remains a controversial topic in medical circles. Why? Let's consider the following observations:

1. THE PSA IS NOT DIAGNOSTIC FOR PROSTATE CANCER. Most causes of an elevated PSA are not caused by cancer (Benign enlargement - BPH or inflammation prostatitis ). Less than 1 in 3 men with an elevated PSA (greater than 4.0) will have a biopsy positive for cancer.

2. A NORMAL PSA DOES NOT COMPLETELY "RULE OUT" THE POSSIBILITY OF CANCER. About 20% of cancers are found in men with a PSA of less than 4.0. That is why a digital exam is done in addition to the PSA . If the physician discovers a suspicious nodule on exam, a biopsy may be recommended regardless of the PSA level. This is an uncommon occurrence but I've had a handful of instances where the exam findings, not the PSA, triggered a referral to the urologist.

3. THE PERCEPTION THAT EARLIER DETECTION OF PROSTATE CANCER WILL REDUCE THE RISK OF DYING FROM THE DISEASE HAS NOT BEEN DEMONSTRATED. Research is ongoing, but for now, we cannot claim that prostate screening saves lives.

So what should we do? Granted, the test has it's limitations, but I support the recommended guidelines of the American Cancer Society--

DRE & PSA for men over 50 yrs old
DRE & PSA for high risk men (African American or strong family history) starting at age 45 yr.
The PSA is still the best available - just be aware of how to interpret the results.

PRACTICE UPDATE
We are a little late with our news letter due to the great response we have had from our Peoria Journal Star article. In addition, we also had a nice feature in the Labor Paper and I had a couple of community speaking engagements (Hult Center and Rotary Club).
We thank you for your support, and we wish you a HAPPY FATHER'S DAY.
Mike & Marilyn