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As I wrote yesterday, for years the message from health care providers and cancer awareness groups has been consistent and clear: early detection through regular screening saves lives. In an unexpected move, the American Cancer Society is beginning to question this long-held conventional wisdom. As it turns out, aggressive testing for breast cancer and prostate cancer may do more harm than good.

It seems odd to say, but early detection of cancer is not a silver bullet. While mammography and the PSA prostate test have lead to higher rates of diagnosis, it is not clear that this has resulted in an equally high rate of successful treatment. The most dangerous cancers tend to develop so quickly that most of the damage is done by the time they are detected. In contrast, many harmless cancers – most of which would otherwise go unnoticed for a lifetime – are detected and treated due to aggressive screening. The discordant result is that many people are receiving treatment they don’t need, while others are receiving treatment that won’t help.

Now for a personal note: This is not to say that screening is useless. As a matter of fact, as I disclosed in “Watch and Wait” Approach to Low-Risk Prostate Cancer is as Effective as Aggressive Treatments, I am such a patient. Even before I was diagnosed I was writing on the topic The Most Feared Complication of Prostate Biopsy. After performing my research and due diligence, at age 53 and being otherwise healthy (not to mention having a wife who, at age 51, is a 10-year survivor of breast cancer and two wonderful children ages 21 and 17) robotic surgery became the best option for me. I am two weeks post surgery and I feel great. The doctors and staff at Florida Hospital Global Robotics Institute in Celebration, Florida, were fantastic. My lead surgeon Vipul Patel, M.D. has performed more robotic prostatectomies than anyone else in the world – over 3,000. Despite his prominence in the field, he and his chief assistant Marcelo Orvieto, M.D. were very accessible before and after my surgery and I can’t say enough good about the entire team. I would like to take a moment to thank Dr. Patel and the staff.

Targeted testing combined, in some cases, with a conservative “wait and see” approach may be the best option for some people. Be sure to talk to your doctor about your cancer screening options, and ask questions. Taking an active role in your care will help keep you healthy for years to come.


  1. Gravatar for jeffrey dach

    Although PSA screening eradicated advanced prostate cancer from the population, there was a downside.

    According to Welch's report in August JNCI, one million men were overdiagnosed and overtreated for prostate cancer over the last twenty years.

    Why was PSA Screening for Prostate Cancer, a 20 year failed Medical Experiment ? Get the whole story here...

  2. jeff,thank you for your comment,your interest and research as your information will be helpful to all those confronted with the real-life decisions that i was - the more information the better - the more conversation and disscussion the better - as for me at age 53 my pathology diagnosis is: prostate,robotic radical prostatectomy:prostatic adenocarcinoma,AJCC stage pT2c,NX,MX(stageII),gleason score 3+3=6/10,approximately 8-10% involvement, NEGATIVE SURGICAL MARGINS. to me that means a cure and so far i feel great.

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