Life expectancy a factor in PSA testing

How long a doctor expects an older man to live is the new determining factor for whether the man is screened for prostate cancer, U.S. experts say. Dr. David Samadi -- vice chairman of the department of urology, and chief of robotics and minimally invasive surgery at The Mount Sinai Medical Center in New York -- said the newly released American Society of Clinical Oncology guidelines put into writing what prostate cancer experts have been espousing for years. The ASCO guidelines advise men with a life expectancy of less than 10 years to forgo routine PSA screening, suggesting the potential side effects and potential complications of treating prostate cancer may outweigh the benefits. For men with a life expectancy of 10 years or more, the guidelines support a man's right to choose, encouraging a thorough discussion of the benefits and risks of testing, Samadi said. "It's personalized medicine, plain and simple," Samadi said in a statement. "Whether 10 years is the magic number for PSA screening depends on the patient, but the recommendation that men have a choice gets us back on track." The PSA debate came to a head in this year, fueled primarily by concerns over whether a man should expose himself to the potential side effects of prostate cancer treatment, chief among them problems with urinary incontinence and the ability to have sex. "Is it worth it? That's what they're asking. But that's a choice each man must make for himself," Samadi said. "As experts, our role is to provide an accurate picture of their health and an education about the pros and cons of prostate cancer testing and treatment."