Probably the most widely used test for prostate cancer is the annual PSA (prostate-specific antigen) test, which measures the blood levels of a protein that both cancerous and benign prostate tissue produces. With just the jab of a needle to take blood samples, it’s quicker, simpler, less expensive, and less invasive than a prostate biopsy (or even a digital rectal exam).
But especially for men 70 and older, its usefulness has come under question.
Yes, PSA screening might help detect prostate cancer early, and the earlier it’s detected the easier and more likely it is to be cured.
But:
· Prostate cancers usually grow very s-l-o-w-l-y and generally never spread to other parts of the body. Far more men die with prostate cancer than from it.
· It’s not the most accurate of tests. You could have elevated PSA levels when there’s no cancer and normal, lower, levels when there is. Because PSA can very from causes other than cancer, false positives and false negatives are common.
· Across all ages, routine PSA screening leads to life-saving cancer treatment for only one in every 1,000 men tested.
· For older men, there are usually too few years left for prostate cancer to become really life-threatening. Heart attacks, strokes, diabetes, and even other forms of cancer work faster.
· With prostate cancer treatment’s complications, including erectile dysfunction, urinary incontinence and bowel dysfunction (to say nothing of the costs), the harms of PSA testing can outweigh the benefits.
· Living with the knowledge that you’re living with a cancerous tumor – even one growing too slowly to need treatment – can cause stress and anxiety.
That’s why, except for cases where there’s urinary difficulty, family history, drug side effects, or other actual symptoms (which you should see your doctor about), more and more medical organizations are recommending than men in their 70s and up skip the PSA test.
· The United States Preventive Services Task Force doesn’t recommend PSA screening for men of any age.
· The American Urological Association says that routine PSA screening may be okay for men 55 to 69, but that men 70 or older with less than 10 to 15 years’ life expectancy should forgo them.
· American Cancer Society guidelines don’t recommend PSA screenings for men with no symptoms whose age or poor health makes it unlikely they’ll have more than 10 years to live.
The consensus is that, like most medical procedures, PSA prostate cancer screenings call for balancing harm and benefit. And as people age, there's less potential benefit and more potential harm.
A similar principle is at work in senior care overall. While too little care can be harmful, too much wastes money and can undermine independence. That’s why the first thing we do at Senior Insights is to conduct a thorough three-part needs assessment with potential clients and their families.
Then, and only then, do we custom-design a holistic senior care management program that fits not only their health needs, but also but also on their own individual likes and dislikes, values, priorities, preferences, schedules and interests. It’s a program with just the type and amount of care that’s needed, no more or less.
Please contact us to lean more about senior care management planning that saves the two costs of unnecessary overcare: the monetary cost and the cost to independence.
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