Sam Black’s father died of prostate cancer in 1991 at age 74 after initially putting off treatment. Black himself was treated for prostate cancer three years ago and, at 70, is doing well today.
Black credits his family doctor for doing regular prostate-specific antigen, or PSA, screenings.
“If it wouldn’t have been for my family doctor, I wouldn’t have known about it and would be in different shape today,” says Black, of Harrisburg.
Count Sam Black and his wife, Diane, as two who do not support the recommendation of the United States Preventative Services Task Force released in May of this year. The task force suggested that no PSA screenings be done on men of any age.
Terry and Kari Housner of Lancaster County also do not agree with suspending PSA testing. Terry, 52, had prostate surgery in April. The father of three, including a 2-year-old girl, Housner wants to be around to watch his young family grow.
The United States Preventative Services Task Force report concludes “that there is moderate certainty that the benefits of PSA-based screening for prostate cancer do not outweigh the harms.”
We can be more selective about who is treated and who isn’t. To stop looking, that doesn’t make sense.
Because some prostate cancer, about two-thirds, is slow-growing, many men might never have problems related to the cancer and will die from something else. But most men, about 90 percent, elect to have immediate treatment for the cancer. The harm that the report alludes to is that treatments themselves can cause death or many other problems, such as incontinence and impotence.
Two local physicians are also not on board with the task force’s findings. Instead of not looking for prostate cancer, as the report suggests, they believe physicians need to be more selective about who gets treatment right away.
“I definitely think changes can be made; we can be more selective about who is treated and who isn’t. To stop looking, that doesn’t make sense,” says Dr. Frederick Newton of Urology of Central PA in Harrisburg.
Dr. Paul Sieber of Lancaster Urology believes it is a bad idea to go back to ignoring the possibility of prostate cancer. The problem, he says, is not finding the cancer; it is not over-treating it. The vast majority of men who come to urology practices these days, Sieber says, have potentially curable disease, instead of advanced disease. “I shudder at the thought of going back to the old days when we could only offer late treatment,” he says.
Newton believes that the conclusions drawn by the task force are “money-driven.” He cites the report from five years ago that suggested mammograms be cut back. “It is the same panel,” he says.
“What they’re saying is if you don’t look for it, you won’t find it. The next step is you don’t have to pay for it,” says Newton.
FAMILY FIRST
Terry Housner had no family history of prostate cancer. When his PSA doubled in one year, he had a biopsy, which showed that he had cancer. Because of his young family, he didn’t want to take any chances. He had his prostate removed at Fox Chase Cancer Center in Philadelphia.
Housner’s doctor told him he could wait a while to have the surgery, but after seeing his mother and others who have suffered with cancer, Housner wanted to have the gland removed sooner rather than later.
Housner is glad he had the PSA test. “If I hadn’t had that done, I wouldn’t even know I had this,” he says. His post-surgery three-month PSA was fine.
Kari, Terry Housner’s wife, is also grateful for the PSA test. “A friend of mine’s husband died of prostate cancer. He discovered it too late. How do they know in 10 years how these guys who are diagnosed are going to be? It could be too late,” she says.
ACTIVE SURVEILLANCE
While Sieber does not agree with the task force report, he does agree with active surveillance as an option after a man has been diagnosed with a slow-growing prostate cancer. He has learned from his involvement with a clinical trial of active surveillance at Lancaster Urology.
Patients in the trial who were diagnosed seven years ago, for example, “haven’t progressed at all,” says Sieber. “No intervention served them well,” he says. Sieber has been involved in 150 clinical trials and also publishes articles.
Both Sieber and Newton state that first you have to find out if a patient has the slow-growing or aggressive form of prostate cancer.
The only way to do that, says Newton, is with a biopsy.
“The best thing we have now to select out people who almost certainly don’t have tumors from those who might is the PSA blood test,” says Newton.
In Canada, the policy is to watch and wait with the slower form of prostate cancer, treating only the aggressive form, and according to an article in the Toronto Sun from June 17, that policy is showing good results. The article states that the United States has been slower to adopt the active surveillance practice for those who have slow-growing tumors, so the United States statistics on lives saved versus how many men have been treated don’t look as positive.
But Rebecca von Goetz, executive vice-president at Prostate Cancer Canada, says in the Toronto Sun article that new Canadian statistics indicate that early detection is working. “The early detection tool is saving lives,” she says.
HELPING OTHERS
Sam and Diane Black went through a life changing experience together and it made their relationship stronger. The benefit of their experience has also helped many others.
Three years ago, Sam, 70, was diagnosed with prostate cancer. Now, he is cancer-free and involved in his community. Sam, who had radiation treatments at Prostate Cancer Center, Harrisburg, credits his family doctor for doing regular PSA screenings.
Sam and Diane have volunteered for three years with the Great Prostate Cancer Challenge, a race and walk that benefits ZERO, The Project to End Prostate Cancer. This year’s challenge is Sept. 28 on City Island in Harrisburg.
The couple also takes part in a support group called Man to Man at Urology of Central PA/Prostate Cancer Center, where Sam was treated. He has shared his experience with many men who are seeking information before they make a decision about treatment.
