“Low risk” prostate cancers picked up by PSA testing are best treated with a “wait and see” approach rather than consenting to an operation.
 
That’s the conclusion of a new study highlighted in the Daily Telegraph medical column which warns PSA testing has led to “an inordinately high cost” in post-operative harm.
 
Writing in Doctor’s Diary, Dr James Le Fanu says “despite the best efforts of the most accomplished surgeons, the majority of patients are still, a year after surgery, impotent and having to wear adult diapers.”
 

New Directive on PSA Test Results

It’s taken the profession 25 years to get to it, but the benefits of treatment are so equivocal, and the consequences of treatment so adverse that UK doctors are now recommending the “wait and see” approach.
 
Says Dr Le Fanu: “The logic behind the test seemed, initially, unassailable, since it can detect the presence of tumour cells in the prostate gland 10 years or more before they become apparent – allowing time to extirpate them before they cause any mischief.”
 

Mortality Rates Same

Continues Dr Le Fanu: “This does, by definition, prevent the cancer from spreading, but the overall impact on the disease has proved to be much less than predicted.”
 
Researchers found men in Connecticut had exactly the same prostate cancer mortality rates as men in Seattle, where the PSA testing regime was five times higher.  Rather than the anticipated benefits in terms of longer lives and better outcomes, there was no difference in the death rate – and a very high rate of collateral damage from treatment.