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Screening Debate Typifies Prostate Cancer Uncertainties
Date:8/10/2012

By Serena Gordon
HealthDay Reporter

FRIDAY, Aug. 10 (HealthDay News) -- Though prostate cancer makes the news a lot, much of the information seems conflicting or inconclusive, leaving men with few absolute answers.

Which treatment is most effective? Which has the fewest side effects? And who might benefit most from screening for prostate cancer?

The dilemma posed by screening perhaps typifies the haze surrounding prostate cancer issues.

"The problem with screening is we know that you have to screen a lot of people and treat a lot of people to prevent one death," explained Dr. Ian Thompson, director of the Cancer Therapy and Research Center at the University of Texas Health Science Center in San Antonio. "Right now, you have to screen at least 1,000 men and treat between 20 and 50 to prevent one death. That person unequivocally benefits from screening, but at the same time, many men were treated who didn't need it."

That's key because the risks of screening aren't trivial, he said. The possibility of a false positive is significant, and that finding then leads to a biopsy, which can cause excess bleeding or infection. It's also possible to find a cancer that may have been inconsequential, so screening can lead to overtreatment.

Complications from treatment also may include surgical complications, urinary incontinence and sexual side effects.

"Now you have a man who has to take Viagra or who becomes sexually inactive, or who has urinary incontinence or other complications, and those are significant," Thompson said. "And, while those complications may seem small compared to saving a life, there are far more people affected by complications than people saved."

Ruth Etzioni, a biostatistician and researcher at the Fred Hutchinson Cancer Research Center in Seattle, agreed.

"The reason why people can't come to an agreement about screening [for prostate cancer] is that it's not all good," E
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