THIS STORY HAS BEEN FORMATTED FOR EASY PRINTING

False hope is not a favorable result of prostate screening

June 30, 2009
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SENATOR JOHN Kerry and Don Imus (“The silence on prostate cancer’’) are right about issues regarding access to healthcare for prostate cancer involving African-Americans. But their June 21 op-ed also leaves the wrong impression.

As an oncologist who cares for patients with advanced prostate cancer, I know that for many of my patients, screening or “early’’ detection would have not changed the final outcome. Kerry and Imus risk victimizing these patients again, making them feel that if only they had a blood test or an examination earlier, that they would not be in this situation.

Prostate cancer is incredibly complex, and some of the effort aimed at promoting screening might be better spent trying to understand why some prostate cancers are relatively aggressive and others relatively slow-growing. In fact, so far studies, although flawed in some aspects, suggest that screening of even high-risk populations such as African-Americans might not lower the death rate much. Furthermore, we are discovering that many men recently diagnosed with this cancer don’t seem to need treatment, at least not immediately.

Tom Farrington’s work with the Prostate Health Education Network in raising awareness is important. However, part of the awareness is the understanding that simply screening alone in its present form, even for men at age 45, will not lead to the nearly 100 percent survival after five years that Kerry and Imus claim.

Dr. Glenn Bubley, Walpole
The writer is on staff at Beth Israel Deaconess Medical Center and is an associate professor at Harvard Medical School.

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