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The Checkup

By Adapted from voices.washpost.com/checkup
Tuesday, September 15, 2009; HE04

Prostate Cancer Screening's Toll

A blood test commonly used to screen for prostate cancer has led many men to get unnecessary treatment, according to a study by H. Gilbert Welch of the VA Outcomes Group.

The prostate-specific antigen (PSA) test measures a protein in the blood that is produced by the prostate gland. Doctors started using it routinely around 1987 to spot men with prostate cancer early. But because prostate cancer grows so slowly, it never causes problems for a lot of men who have it.

Welch analyzed federal cancer statistics between 1986 and 2005 and calculated that 1.3 million men had been diagnosed with prostate cancer since PSA testing began. Of those, more than 1 million underwent treatment, most of whom probably did not need it, according to a report in the Journal of the National Cancer Institute.

For every man whose life was saved by PSA testing, at least 20 underwent unnecessary treatment that may have left them incontinent, impotent and suffering from other side effects, the researchers calculated.

-- Rob Stein

ewellman wrote:

This article makes me very cross. This test saves lives. My partner is only 67 and the cancer has spread to his bones, so I know all about the anguish of this disease. I would do anything to encourage all men to have a PSA test every year.

Directmale wrote:

Prostate surgery is not done solely on the basis of a PSA test. A biopsy is performed, and if it is found to be positive, the patient decides what treatment he wants. I am 60, had prostate cancer at 42, and would have been dead nearly 10 years ago if I had not had the surgery. I have none of the problems listed in the blog post.

In Praise of Thunder Thighs

According to a study published in the online journal BMJ (http://www.bmj.com), men and women with small thighs face a higher risk of having heart disease and of dying prematurely.

The Danish study followed nearly 3,000 people, roughly half men and half women, for 12.5 years after measurements of their thighs, hips, waists, height, weight, blood pressure and body-fat composition were taken.

After controlling for risk factors such as smoking, high cholesterol and overall body fat, the researchers found that having larger thighs was associated with less likelihood of succumbing to cardiovascular disease or early death. The protective effect of bigger thighs only extended so far, though: Thighs measuring more than about 24 inches around didn't correlate with better health.

Researchers expressed regret that they hadn't measured the fat-to-muscle makeup of participants' thighs, as they surmise that having larger thighs by virtue of having more muscle mass may have made the difference between good health outcomes and bad. (More muscle mass is thought to combat insulin resistance, thus warding off Type 2 diabetes and, by extension, heart disease.)

-- Jennifer LaRue Huget

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