If you look at the various guidelines for PSA testing you will see that they generally include counseling the patient about
the risks before he decides to have the test done. Both my parents, all of my three siblings, my daughter and a couple of nephews are all medical professionals (yes, as a computer jockey I am the black sheep of the family) and the various points about
the psychological wall between a doctor and the diseases he/she treats are quite valid. But, having said that, it is quite likely that all of the doctors we are talking about
believe that those dangers of PSA testing are real and pressing.
The problem with PSA testing, and the motivation for my Alexander Pope quote above, is that PSA screening and the diagnostic cascade that follows often provide exactly that "little bit of knowledge" that is a dangerous thing. A diagnosis provides a spur to action which is very hard to ignore while, at the same time, providing very little information in most cases as to what action, if any, is actually needed.
In a way, an oncologist with a family history who doesn't worry about
his PSA or about
early diagnosis is showing confidence in his own medical specialty. He is, in effect, saying that with current and emerging treatments he feels that advanced prostate cancer can usually be managed and he'd just as soon take those risks rather than putting up with the risks involved in early detection and (often futile) attempts at a cure.
I can see his point. But, unfortunately, I have a bad attitude about
the current and foreseen treatments treatments for advanced disease. A recent posting here talked about
the new guidelines for treating advanced disease.
The first few lines said...
These are the new guidelines coming from the American Society of Clinical Oncology (ASCO) and Cancer Care Ontario (CCO) for Men with Advanced Prostate Cancer
* Continue hormone-deprivation therapy indefinitely, either in drug or surgical form;
There were other bullet items but I had lost a lot of interest after the first. I went on reading but at the same time I was really, really, really
hoping that my remission can continue for a long, long time.