Not Ordering Further Tests After Abnormal Results Could Lead To Advanced Prostate Cancer

With prostate cancer there are two tests that are used to screen for the cancer before any symptoms appear

. The concept is to diagnose the cancer early - before it is able to spread while treatment is likely to eliminate the cancer instead of waiting until the cancer advances and spreads at which point there is at this time no known cure. The first is a physical examination of the prostate gland for any abnormalities that might be due to prostate cancer. The second is a blood test referred to as the PSA test. An abnormally high result signifies the chance of prostate cancer.

If an issue other than prostate cancer causes the PSA level to rise the elevated PSA is referred to false positive. There are also possible dangers correlated with biopsies, including excessive bleeding and infection. Because of these 2 issues a number of doctors advise that male patients use a plan of watchful waiting. Under such a plan the doctor tracks the patients elevated PSA during a time spanning of months or even years. In this period of time some physicians advise that the man go on non cancer related treatments, such as, for infection, based on the theory that if the PSA is high for a reason other than prostate cancer such treatments may bring the PSA back to normal levels.

One of the issues with this strategy is that a physician may wait too long before recommending a biopsy. As the PSA goes up the likelihood rises that the rising levels are from prostate cancer, and so does the possibility that the cancer has metastasized. Men with prostate cancer who have a PSA level lower than 10 ng/mL have between seventy to eighty percent chance of having organ-confined disease, as opposed to fifty percent for men with PSA levels 10 to 50 ng/mL, and only 25% with higher PSA levels

Treatment options for advanced prostate cancer may include hormone therapy, radiation therapy, orchiectomy (the surgical removal of the testicles), and possibly chemotherapy. Treatment will usually cause the PSA to drop significantly for awhile. In time, treatment may stop working and the cancer will again continue to advanced. After the treatment no longer works, the cancer is fatal. This year, approximately ninety thousand men will die in the U.S. due to advanced prostate cancer.

What percentage of these 90,000 deaths will be due to a physician advising the manhis patient to stick to the "watchful waiting" method and then did nothing while the cancer spread? Perhaps we may never know how many of these mens lives might have been saved had the physician advised the patient to undergo a biopsy.

By taking a watchful waiting strategy and merely keeping track of a man's elevated PSA, a physician puts the man at risk of not doing anything about the cancer until it gets to an advanced, possibly untreatable, stage. This may amount to a departure from the standard of medical care and may result in a malpractice claim.

by: Joseph Hernandez

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