Midwest Robotic Surgery Blog

Recently, there has been a hoopla on the effectiveness of PSA screening for prostate cancer.  Does PSA save lives?  Should we keep screening men?

The following is not in dispute, 1)Prostate cancer deaths have decreased in the US since we started PSA screening.  This is based on our large Medicare cancer database (SEER).  2) A long term randomized trial from Sweden showed conclusively that men undergoing radical prostatectomy lived longer than men on observation, i.e, treatment can save lives.

A new study from the Cleveland Clinic demonstrates that men in the pre-PSA era were at much greater risk of developing metastatic disease after being diagnosed with prostate cancer.  Men treated prior to the PSA era were 3x more likely to develop metastatic disease compared to men treated in the PSA era.

Naysayers suggest that PSA led to diagnosing a large number of low risk prostate cancer, artificially lowering the death rate.  That may be true, but this new study certainly suggests that the risk of dying of metastatic disease is lower today than it was 20 years ago.  I believe PSA has saved lives