Stand Up to Cancer and the PSA test -- yes, no, maybe?

Do you like to read about ethical hanky-panky in the world of science and medicine? Check out Integrity in Science Watch, a project of the Center for Science in the Public Interest. (That's the consumer advocacy group better known for its analysis of restaurant food and periodic releases dubbing dishes such as fettuccine al fredo "heart attack on a plate.")

Undisclosed affiliations with pharmaceutical companies? They're here! Potential cherry-picking of scientific data? It's here too! The press get a drubbing, too, with "cheers" or "jeers" awarded for examples of squeaky clean reports or ones that missed a beat or two.

One of the jeers this week was "to network anchors Charles Gibson, Katie Couric, and Brian Williams for appearing on the hour-long "Stand Up to Cancer" telethon that ran on all three national networks last Friday ... Among the many unproven statements made during the hour: All men over 50 should get an annual prostate exam, even though the U.S. Preventive Services Task Force recently issued a report questioning its usefulness to men over 75."

The Stand Up to Cancer public service announcement gripe came from University of Minnesota journalism/mass communication professor Gary Schwitzer's health news blog. He takes issue with other aspects of the telethon as well, such as involvement of news media: "There are serious issues to discuss about cancer research in this country. But journalists are undoubtedly less likely to pursue such questions when they're involved in glad-handing endorsement of a cause," he writes. And, "What does it mean that drug companies Amgen and GlaxoSmithKline are listed as "heroes" on the project website?"

Schwitzer's not the only "Stand Up to Cancer" grump out there. Junkfood Science blogger Sandy Szwarc had this and more to say: "Like all advocacy groups, heightening the dangers and seriousness of their cause is fundamental to justifying the need for more and more money to address it. After an hour of watching Stand Up to Cancer, if you weren’t in tears and scared to death that you or someone you love might already have cancer or be next to die if researchers don’t get money now, you weren’t watching. Even the program's website has five pages of terrifying statistics on the deadliness of the cancer epidemic. Unlike the repeated claim of a “growing crisis of cancer,” however, all facts paint a far more optimistic and hopeful picture. But any balance was missing in this program."

As far as the PSA issue goes, you can read a synopsis of the task force recommendations here and the full report, which was published in the Annals of Internal Medicine in August, here.  Its conclusions: "Current evidence is insufficient to assess the balance of benefits and harms of screening for prostate cancer in men younger than age 75 years ... Do not screen for prostate cancer in men age 75 years or older."

Wow. Confusing. I'm sure glad I'm not a man -- except, wait a minute! There are those sparkling-clear breast-self examination recommendations we women have to wrestle with: "Examine your breasts every month" ... "Don't examine your breasts every month" ... "Don't formally examine your breasts, but if you notice anything ..." ... "Examine your breasts every month if you want to, but don't examine your breasts every month if you don't want to, it's really up to you."

-- Rosie Mestel

Comments

[William C. Dressler, M.D.]

As a prostate cancer patient whose life was saved by a PSA, a man should carefully consider the new recommendations if he gets the diagnosis of prostate cancer. Dr. Patrick C. Walsh of Johns Hopkins performed a radical prostatectomy on me November, 1999, and I regained sexual function in three weeks and full urine contol in four months. My PSA is 0.0. With an RRP (radical prostatectomy), the critical issue is the skill of the surgeon; Dr. Walsh had done over two thousand when he performed mine.

[Dave]

Check this out, someone trying to take advantage of the situation via deceptive advertising

Deceptive Advertising: Cancer Centers Try to Piggyback on Charity’s Success

http://www.itsfestive.com/2008/deceptive-advertising-cancer-centers-try-to-piggyback-on-charitys-success/

[SoCalGal]

Dr. Dressler, your point is so well taken. Thank you for making it. Not many people know--and so don't think to ask their oncology surgeon--"How many times have you performed this operation?" If s/he is vague or doesn't know, find another surgeon!

http://www.medscape.com/viewarticle/562045

[Mark Jamieson]

My father took his first PSA test at age 63. His PSA was over 67 and we learned that his prostate cancer had metastasized to his pelvis and femur. At that time he had no symptoms and the news came as a complete shock. Medical specialists gave him six months to two years. He lived for six years after his initial diagnosis by working through various therapies that offered to delay but not stop the progression of his cancer; therapies that seriously eroded the quality of his life. I believe that if my father had started testing for PSA earlier, he would be alive today.

[pat kearns]

My father was diagnosed in his early to mid 70s. Should he have waited, not been treated? Well, he was treated and he's now 94. The AHRQ needs to rethink was "old" is these days. Who is to say at the age of 75 you'll probably only have 10 more years. I have a number of friends my age (62) who were diagnosed in their 40s with prostate cancer after a regular screening and I know each and every one of them is happy to be alive. These are preventable cancers that with early screening raise the survival rates tremendously.

[Rich Friel]

At age 53 in 1996 my PSA was in the mid-normal range. During the summer I had an unusual bout of diarrhea and my PCP ordered a sigmoidoscopy. They discovered a prostate nodule pressing into my large intestine, the biopsy confirmed there was a moderately differentiated tumor in my prostate gland, and they took out my prostate gland.

The point is, the PSA test is NOT a surefire way to indicate whether or not you have prostate cancer. If I hadn't had the bout of diarrhea I would have been dead by 2002.

Rich

[Thomas Borup]

Obviously this board was paid by insurance companies that they don't want to pay for expensive cancer treatments!!!!!! If they don't test and make sure it is hopeless then they don't have to pay for tooo many or any treatments.

The scary part!!!!! it is more then likely a goverment bean counter at medicare who pulled this scam. The test doesn't hurt.... it is what the doctor does with the results that can be questioned.....

[Ken]

They could have added in that men over 75 should forgo prostate exams and PSA test, but this is also something that a physician/HMO should inform men over 75 years of age. I believe the intent was to get men aged 50 of higher to be aware of their responsibility to initiate screening. This seems like a minor quibble.

[Sarah]

Age should not be an issue so far as check-ups go. I am only TWENTY ONE and found lumps in my breast through my self-examination. Being tested regularly and EARLY is much more sensible than waiting, no matter what the statistics say.