In 2012, the US Preventative Services Task Force (USPSTF) stunned the medical and lay community with its recommendation against routine prostate-specific antigen tests or, PSA screenings, for prostate cancer. This screening can detect high levels of PSA that may indicate the presence of prostate cancer. The Task Force gave PSA screening a grade of “D” primarily based on the results of the Prostate, Lung, Colorectal, and Ovary (PCLO) trial, reported in 2009, which showed no difference in prostate cancer incidence or mortality between the screening and control groups after 7 years. Since this seminal declaration, screening has decreased from 33% to 18.7% in men aged 55-69 years, the age range generally thought to be most critical in identifying and treating the second-leading cause of cancer death in men.
In the last few years, the advice on prostate cancer screening has been very confusing for patients, and front of mind for internists and urologists. It’s a pressing concern because in 2012 there were 28,000 deaths from prostate cancer. However, the best approach to screening is still controversial.
In 2009 and 2012, researchers published key trials on prostate cancer screening, and the results only added to the controversy. A large study done in the United States failed to find a benefit to early prostate cancer detection, whereas a large European study did. However, when I say the European study “did” find a benefit, it wasn’t that reassuring. According to a February issue of the Annals of Internal Medicine, the European study found that for every 1,000 men screened, 37 cases of cancer would need to be detected and treated to prevent one death.
Finally, a Study on the Effects of Diet on Prostate Cancer
by Dr. Josh Fink
It would be a huge step forward if, one day, Doctors could tell a man that what he eats directly impacts the progression of his disease. This information might empower our patients to directly affect their health on a daily basis based on their eating habits.
The “MEAL” study (or Men’s Eating and Living), sponsored by the National Cancer Institute, is designed to test whether a high-vegetable diet will lower risk for prostate cancer progression compared to a “standard” diet. The MEAL study is crucial to our understanding of the possible relation between consumption of food/food groups and the progression of prostate cancer.
Robot-assisted Surgery Got its Start on the Battlefield
by Dr. Warren Bromberg
The original destination for guided robotic surgery was the battlefield: The hope was that expert surgeons could operate on injured soldiers remotely. While these plans have yet to pan out, robotic technology has been adapted for civilian use.
Northern Westchester Hospital now has two such devices, the da Vinci® Surgical System.