In 2012, the U.S. Preventive Services Task Force (USPSTF) advised the elimination of a routine prostate-specific antigen (PSA) screening test for prostate cancer in healthy men. Champions for early detection of the disease were not pleased.
“They are doing the male population in this country a huge disservice,” said Robert Marckini, author of the book, “You Can Beat Prostate Cancer” and founder of Brotherhood of the Balloon, a 6,500-member group of men who chose proton therapy to treat their prostate cancer.
The USPSTF said science indicates “there is a very small potential benefit and significant potential harms” in PSA screening, and that routine PSA screening could lead to false positives, which in turn could result in overdiagnosis and overtreatment.
“The problem is not that too many men are being diagnosed with prostate cancer,” said Marckini. “The problem is that men are being overtreated for prostate cancer. So do you throw the baby out with the bathwater? Stop diagnosing the disease because some urologists are being too aggressive and doing surgery on men who could do watchful waiting? No — you educate patients and get doctors to act more responsibly.”
With watchful waiting, patients are not treated, but monitored closely to detect any progression of the disease. If the disease progresses, an appropriate treatment can be prescribed.
The earlier aggressive prostate cancer is detected, the greater the chances of it being contained in the prostate without migrating to surrounding tissues, and the better the chances of considering proton therapy as a treatment.
Prostate cancer is often treated by performing a radical prostatectomy, an operation that involves removing the prostate and any nearby tissue that may contain cancer. However, removing the prostate can often cause impotence and incontinence.
With proton therapy, prostate cancer is treated with very precise, targeted proton beams that target only the tumor volume with minimal impact on surrounding healthy tissues. There is usually no negative impact on the ability to have an erection or to retain bladder control.
“When men find out they have prostate cancer, and the urologist starts talking about morbidity and potential surgical side effects such as impotence, incontinence, strictures, infection and other things, it frightens men,” said Marckini, himself a prostate cancer survivor who underwent proton therapy 12 years ago. “But men should not fear getting diagnosed or worry about side effects. Because there is a treatment that can almost guarantee they will not lose bladder control and give them the absolute best chances of maintaining sexual function. And that’s proton therapy.”