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The truth about prostate cancer screening

A few weeks ago, a good friend called me from Lima to ask if it was true that I was against any kind of prostate surgery and sent me an article that said, “Dr. Elmer Huerta: no more prostate cancer screening.

The prostate is untouchable, its enlargement is by age and is normal. Never let your prostate operate!”. In this text, full paragraphs of some articles published in this journal are plagiarized and mixed with fantasies of the Idle who wrote so much nonsense. Some nonsense is, for example, that men who have a checkup are sadistic, that prostate biopsies do “perforations” that cause “impotence” and that “it is better to die in peace than to die in torment”.

It is time to clarify this matter. With this ‘fake news’ fashion, I wonder: how many men are reading these falsehoods and suddenly refusing a treatment that can save them from the vine.

In this series of articles for Commerce, I have written four times about prostate cancer. The first,” don’t have an unread prostate checkup before this post”, was on August 24, 2009. There I commented on an editorial, published on the 1st of July of that year, in which it questioned the campaigns of detection of prostate cancer in large populations, because it had been discovered that the majority of the cancers found were of low risk and the men were left with serious side effects after receiving a treatment unnecessary. The recommendation was to be checked, but with a prior personalized explanation of the pros and cons by the doctor. In the article, I told that I had already done my checkup and warned that if they found me a cancer, I would fight “toenails and teeth” so as not to let myself be treated if there was no need. Currently, almost half of men with prostate cancer in EE. UU. he doesn’t need treatment.

The second article, “Goodbye to the check-up of prostate cancer”, was published on may 21, 2012 and he reported that, after a long wait, the Working Group of Preventive Medicine of EE. UU. he had concluded that it discouraged mandatory prostate cancer screening in men over 50 years of age. This position was later corrected in 2018, recommending that the doctor and patient sit down and discuss the pros and cons of such a decision.

Part of this article is the one that has been used in the ill-intentioned text circulating on the Internet, so that there is no doubt, I verbatim transcribe the recommendation that we made then: “to conclude, and now it is official, if you are 50 years old or older, do not check for prostate cancer without first reading this post and the previous one”.

As can be read, it was never claimed that man should not have a prostate cancer check, but should be well informed. The third article is entitled “most prostate cancers would not need treatment” and was published on September 7, 2015. In it, we reported the results of a study showing that 67% of prostate cancer cases diagnosed in the United States were diagnosed. UU. you wouldn’t need any treatment because you’re painless and low-risk. The fourth article, published on December 7, 2015, was a first clarification of the written spurious.

Corollary

These are the current prostate cancer screening recommendations of the American Cancer Society: always after a frank explanation of the risks and benefits of the check-up, high-risk men (black or with a parent or siblings with prostate cancer before age 65) should start the check-up at age 45. Men at very high risk (those with a parent or siblings with very young cancer) should consider having their checkup at age 40. Men at average risk should start at 50. The check-up consists of a blood measurement of the Prostate-Specific Antigen (PSA) and a digital rectal examination.

Finally, it seems that prostate cancer shows its aggressiveness from the start, so, if a man has a normal initial prostate checkup, it is not necessary for him to do it every year. In this regard, the American Cancer Society recommends that if the initial level of PSA is less than 2.5 nanograms (nm), the check-up should be done every two years and that only those with PSA greater than 2.5 nm should do so each year. And finally, the age limit for the checkup is 75 years. Continuing to check on older men is not good medical practice.
We hope that our position on prostate cancer has been made clear. That is to say, that the check of the prostate is necessary, but that before doing so it is important to receive information of the cons and pros, which the prostate biopsy is the only way to know if there is cancer and, finally, that –if indicated– the treatments are very important and can save the patient’s life.

If you ever receive that malicious article that circulates on the Internet and contains alleged claims attributed to this columnist, return it to the sender, clarifying that everything that is secured there is false.

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