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Prostate Cancer Screening in Primary Care

Dave Sharkis, MD
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Guidelines give conflicting recommendations on whether or not to use PSA for prostate cancer screening. David Sharkis gives his approach, recommendations, and scripting for shared decision making.

 

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Ian L., Dr -

Another option in discussion is to discuss the fact that whilst most prostate cancer are very slow growing there are 10-15% that are aggressive and worth treating early .Chang AJ et all in Nature Reviews Clinical Oncology 11 308-323 notes that "238,590 men were diagnosed with prostate cancer in 2013 and 29,720 were anticipated to die of their disease "
That figure is about 10% of those diagnosed close to the number (10-15%) with 'high- risk prostate cancer .
It's important I believe to explain this to men and their families especially those who have at least a 5 -15 plus year survival expectancy as these aggressive prostate cancers can rapidly spread and if identified early a chance of years life extension at the minimum is expected with treatment .

Robert S., MD -

How significant to others find the fact that while the European study shows a small prostate cancer death benefit, the all cause mortality is no different? Do patients differentiate as to how they die? Or is dead dead?

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C Diff Shows No Mercy! Full episode audio for MD edition 186:21 min - 87 MB - M4AHippo Primary Care RAP June 2016 Summary 852 KB - PDF

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