Murray S. Feldstein, MD
Potential Conflicts of Interest: None disclosed.
Feldstein M.; Screening for Prostate Cancer. Ann Intern Med. 2012;156:540. doi: 10.7326/0003-4819-156-7-201204030-00016
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Published: Ann Intern Med. 2012;156(7):540.
TO THE EDITOR:
Although there is much to applaud in Chou and colleagues' review (1), their conclusions may do more harm than good. The authors have studied mortality as a primary end point. As an elderly urologist who spent almost half of his career in the pre-PSA testing era, I can personally attest to another and perhaps even more important factor that is being overlooked—that of patients with advanced prostate cancer.
I no longer see patients with bulky types of cancer that bleed and obstruct their urinary tracts. Many of these patients required emergency procedures and were left with permanent indwelling catheters. The patient presenting with diffuse painful osseous metastasis is now rare. Emergency orchiectomies plus radiation or surgical decompressions for impending paraplegia also seem less common.
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