Prostate cancer surgery is routinely performed when medically unnecessary

Apparently the PSA test does effectively ascertain whether a cancer is life threatening vs. a dormant cancer that will not affect the patient's life. New tests will need to be developed before thousands more men go through needless surgical procedures, potentially damaging their health for life.

• Thousands of men may have unnecessarily undergone an invasive operation to remove their prostate, sometimes suffering impotence and incontinence as a result, because of a screening test which was yesterday written off as all but useless.
• It will tell doctors that a man has a prostate cancer, but scientists in the US said yesterday that in many cases the man can live with the cancer and the treatment may be worse than the cure.
• "The PSA era is over," said researchers at Stanford University school of medicine in their paper in the Journal of Urology.
• The team studied prostate tissues collected over 20 years, from the time it first became standard to remove prostates in response to high PSA levels.
• Professor Stamey said he had also come to believe that the PSA test was not a useful predictor of the amount or severity of prostate cancer.
• Tumours found 20 years ago were generally so large they generated PSA levels high enough to provide a reasonably good measure of cancer severity.
• But he said that, as screening became more commonplace, many cancers were being caught earlier and were usually smaller, not generating sufficient PSA to be a good indicator of severity.
• He said prostate cancer was a disease all men got if they lived long enough so, given the excuse to carry out a biopsy, doctors were most likely going to find cancer.
• Prof Stamey said the PSA was still useful in monitoring patients after removing the prostate as an indicator of cancer that had spread to other parts of the body.
• Men without symptoms who chose to have a test in the first place were probably then more likely to opt for surgery rather than the "watchful waiting" that some experts advocate.