The recent Buffalo News editorial (Oct. 22) by University of Minnesota professor and blogger Gary Schwitzer wags an accusing finger at Roswell Park Cancer Institute's prostate cancer awareness campaign for saying too little about the controversy concerning the challenges and value of mass prostate screening.
There is legitimate concern that widespread use of the PSA test may overdiagnose prostate cancer and put men at risk for complications from unnecessary treatments such as surgery and radiation. Roswell Park developed the PSA test for prostate cancer detection and management, and we are well aware of the test's advantages and limitations. In fact, our researchers are working hard to improve the PSA test to make one better able to ferret out prostate cancers that are potentially aggressive and life-threatening.
Ironically, the Prostate Club for Men was started because of the “heard-loud-and-clear” messages from many men in our community -some of whom came to Roswell Park confused by “first time” elevated PSAs - who said that they felt that they were being rushed into cancer treatment. Men with elevated PSAs who come to Roswell Park for answers are told three things: 1. Don't panic. Elevated PSAs do not always mean cancer. 2. Don't rush into decisions. 3. Get a second or third opinion and assure that recommendations you receive are vetted through current national guidelines and evidence-based medicine.
Roswell Park also established a High Risk/Early Detection Prostate Cancer Clinic for men who have been told they have an elevated PSA, and who would like a Roswell Park expert to evaluate their results and recommend next steps. Many times, those “next steps” include “watching and waiting” (or active surveillance) which is recommended for men in whom evidence indicates that their cancer does not need to be treated.
Talking to one's doctor about screening is not the same as being treated, and we believe that Mr. Schwitzer muddies those issues. Is his takeaway message to men: Don't talk to your physician? Is it: What you know can hurt you? Prostate Club members are encouraged to be their own health advocates, to seek out the facts about prostate cancer and to have a discussion with their physicians about whether (and when) testing is appropriate for them. Many men do not even know what it means to be at “high risk” for prostate cancer.
Prostate cancer screening is “quick and simple” - deciding what to do with the information it yields is not. The American Cancer Society urges men “to have an opportunity to learn about the benefits and limitations of testing for the detection and treatment of early prostate cancer.” The Roswell Park position concurs: come on guys, lets talk.
Editor's Note: Dr. James Mohler, Senior Vice president for Translational Research and Chair of Urology at Roswell Park, will be available for media interviews. Dr. Mohler is Chair of the 24-member National Comprehensive Cancer Network's Prostate Treatment Guidelines Committee. NCCN guidelines, which are based on scientific data, are the most widely used standards for cancer care in the world.
The mission of Roswell Park Cancer Institute (RPCI) is to understand, prevent and cure cancer. RPCI, founded in 1898, was one of the first cancer centers in the country to be named a National Cancer Institute-designated comprehensive cancer center and remains the only facility with this designation in Upstate New York. The Institute is a member of the prestigious National Comprehensive Cancer Network, an alliance of the nation’s leading cancer centers; maintains affiliate sites; and is a partner in national and international collaborative programs. For more information, visit RPCI’s website at http://www.roswellpark.org, call 1-877-ASK-RPCI (1-877-275-7724) or email firstname.lastname@example.org.
Annie Deck-Miller, Senior Media Relations Manager