Prostate screenings urged

Although prostate cancer is very treatable when detected early, an estimated 27,000 American men will die from it this year. And nearly a quarter million will be diagnosed with the condition as well.

"It's a leading cause of cancer death in men in the United States," says Dr. George W. Middleton, a urologist at Cottonwood Hospital. Middleton and Dr. Blake Johnson, a urologist practicing at LDS Hospital and Salt Lake Regional Medical Center, will be featured on the Deseret Morning News/Intermountain Healthcare Hotline Saturday from 10 a.m. to noon, where they'll take called-in questions.

Because it's generally — but not always — a slow-moving cancer, many of the men diagnosed with prostate cancer will not die from it. Elderly patients who receive the diagnosis are apt, in fact, to die of something else unless their cancer is advanced, according to Johnson and Middleton. For some, active treatment isn't always the best option, depending on age and other co-existing health conditions.

But Middleton is befuddled by people who claim that prostate cancer doesn't need to be evaluated or treated. Many people have been killed by the disease. And many of them did not need to die from it.

Each year, Middleton says, there are 211,000 new cases of invasive breast cancer diagnosed, a number smaller than that for prostate cancer. The number of deaths is somewhat higher for breast cancer, but they're comparable. "No one would think of not treating breast cancer," he says. "This doesn't make a lick of sense to me. With an equivalent number of diagnoses and an equivalent number of deaths, why shouldn't they both be treated?"

Early detection not only improves the chance of survival, but it also allows patients and doctors to take some time to make decisions about treatment. There are a number of options, from "watchful waiting" to radiation or complete removal of the prostate.

Effective screening involves two different tools: a blood test that measures prostate-specific antigen (the PSA test) and a digital rectal examination, starting at age 50. Cancer experts recommend that those with a brother or father who had the disease start screening annually at age 40.

The tests are not foolproof. Each has about a 20 percent false negative rate, but combined they are very effective in finding prostate cancer, Middleton and Johnson agree.