A new study finds men over 75 shouldn’t bother getting prostate cancer screenings, but one Iowa expert disagrees. Dr. Richard Williams, head of urology at University Hospitals in Iowa City, says you can’t make a blanket statement about all patients and they should all be treated individually.
Dr. Williams says, "If they come in and they have multiple co-morbidities like heart disease, other cancers, etcetera, then the likelihood of living five to ten years is not very (good) to begin with and to try to determine whether they have prostate cancer may not be useful to them." By the same token, he says an otherwise healthy older man may benefit greatly from a screening.
Williams says, "A 75-year-old comes in who has no other illnesses, his parents lived to 95, he has a good chance of surviving and it might be useful to be sure he doesn’t have prostate cancer." The study from the U-S Preventive Services Task Force found that screening can detect some cases of prostate cancer, but the benefits of treatment in men over 75 are small to none, while treatment often causes moderate-to-substantial harm.
Williams says prostate cancer is the most common cancer in men and it’s the number-two cancer killer of men. "Men who are 70 or older tend to have prostate cancer about 70-percent of the time," Williams says. "If you were to take out everybody’s prostate and look at it, that’s what you’d find, but, importantly, a very low percentage of those patients who have prostate cancer will actually progress, so we don’t need to know whether they have it in every patient."
He emphasizes that every man is different and every case is different. "Every patient is an individual," Williams says. "You deal with them and their specifics and you discuss with them the need, or not need, to look for prostate cancer in them." He says men should start getting screened for prostate cancer between 45 and 50, earlier if there’s a family history of the disease.