If you’ve been following this blog for a while you may have noted a number of posts on the dilemma of overdiagnosis and PSA screening for prostate cancer. We used to thing that all cancers has a common characteristic that once established they inexorably progressed, eventually becoming symptomatic and often lethal. We now know that some cancers can spontaneously regress and go away either living their course and dying away or being overcome by their hosts immune system. This has been demonstrated in breast cancers, thyroid cancers and kidney cancers especially. Other cancers like prostate cancer can progress at extremely variable courses, often so slowly that they never become symptomatic in a given person’s lifetime.
Kenny Lin MD, one of my favorite on-line physicians, wrote an interesting editorial in the recent American Family Physician. It outlines two approaches to the PSA screening debate. It is a good brief read. Check out: