Prostate screening guidelines may be troubling for some

Imagine you're a 75-year-old man who's in for a checkup only to find out your doctor is betting you won't live for another 10 years.

The doctor might not put it that bluntly, but physicians who follow new guidelines regarding prostate screening are playing with your health on those odds.

It turns out they may be correct, and you might end up thanking them for their lack of aggressive treatment if you do happen to have prostate cancer.

A federal health agency has concluded prostate screenings may do more harm than good among men over age 75. While aggressive treatment may not do much good, it may also cause "moderate-to-substantial harms" including erectal dysfunction, bladder control and bowel problems.

Like any malignancy, prostate cancer is nothing to take lightly. It's the most common cancer in American men, diagnosed in about 220,000 men each year, and the second leading cause of cancer deaths in men.

But most tumors grow so slowly that older men who have early-stage prostate cancer are not taking a big risk by not treating it right away. The conventional wisdom is that more men die "with" prostate cancer than "from" it.

The federal agency which issued the recommendations, the U.S. Preventive Services Task Force, "could not find adequate proof that early detection leads to fewer men dying of the disease."

Many doctors recommend "watchful waiting" to monitor signs of the disease and treating it only if symptoms worsen, but some studies dispute the safety of that approach.

The American Cancer Society doesn't set a fixed age to stop prostate screening, but does say it doesn't need to be done if men are not expected to survive another decade. Most experts agree testing shouldn't occur before age 50.

But the realization a doctor has, in effect, written off you or your loved one because of age may be hard for many of us to take.

Decisions like those, however, will become more and more the norm rather than the exception as the United States moves toward universal health care.

For now, the only sure advice is to discuss the risks and benefits of prostate screening and treatment with your doctor.