For years, research has suggested men over the age of 75 should not be screened for prostate cancer, which generally grows too slowly to seriously harm oldsters. Yet Gina Kolata reports in the New York Times on a new paper, published in The Journal of Clinical Oncology, that finds that men in their 70s are being screened at nearly twice the rate of men in their 50s  and men ages 80 to 85 are being screened as often as those 30 years younger. Why? Kolata says there are at least two likely reasons: doctors are afraid they could be sued if they don’t screen and a man is found to have a lethal cancer; and money. Doctors are paid for doing the tests and treating the cancer, even if the cancer they are treating is unlikely to kill their patient. Kolata points out that for most men, screening does more harm than good because it leads to biopsies and treatments with unpleasant side effects.
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Saturday, May 31, 2025
ok. I am 65 years old and familiar with statistics. But I don’t want to be that person for whom the PSA was thought to be unecessary and end up with a lethal form of prostate cancer.
I just read that in a group of about 2000 men, half of whom were screened and half not, there was little difference in the death rate. Yet I know a guy who is 73, his PSA shot up, he had a biopsy and had a virulent form of prostrate cancer. He had a prostatectomy and is well today. He is alive and smiling. If I am that one guy who has the cancer, I want the damn test.
Now, if there is a list of symptoms that I can monitor that tell me when I ought to hoof it over to the doc before the cancer has spread, I am ready to do that and not do the PSA. But at age 65+, there are a lot of things happening to the plumbing and it is difficult to know if you need to see the doc or you are just getting old.
Excellent comment, Peter.
As a family doctor, I face these decisions daily. You have pointed out accurately the difference between deciding if something is valuable for the population IN GENERAL from a public health perspective, and deciding if something is valuable to YOU PERSONALLY.
There is a BIG difference, and it’s one of the reasons we should all fear our health care decisons being made by committees deciding for the general good, versus you and your doctor deciding what’s best for you personally. Health systems that take your personal options away and make the screening process one that’s decided by comittees are taking socialized medicine too far in my opinion. If it’s you that gets it, it’s 100% and the statistics the comittee bases it on won’t matter. The best system is one in which you and your doctor have the final say, not your insurer, who bases it on overall costs.
It seems as our country is attempting to make a push for a socialistic style of healthcare more and more “studies” are showing up telling us to disregard common preventative healthcare screenings… hmmm… makes me wonder a bit?
Agreed just like breast cancer screening, I believe a government survey just after Obama-care was passed said it was not necessary as often as women are having the screening done. The bottom line I would rather go through it, and yes as a man in my 40’s it’s not a comfortable check but I believe in 70’s or 80’s if I am still here I will feel the same. I personally know two people in their 70’s who have had prostate surgery to remove cancer.
It is very odd that there are so many fund raisers and emphasis on women’s breast cancer while there is so little attention on men’s prostate cancer. Prostate cancer is as big a killer as breast cancer, check it out yourself. This advice for men to not even bother getting a PSA Test is disgusting”.
I have three personal friends whose PSA tests alerted their doctors to their cancer. One had a Total Prostatectomy, the other two had radioactive seeds and radiation and all three have survived Prostate Cancer. Another man at my church, very recently passed away because of this cavalier attitude about prostate cancer.
I am only one person, so you can see the odds are quite high and Prostate Cancer is a painful and awful way to die. Let’s put the same argument out there for women to stop mammograms for breast cancer and see how many women want to stop this life saving exam.