Policy on Early Detection of Prostate Cancer Finalized
Cancer Care Nova Scotia--Policy on Early Detection of Prostate Cancer Finalized
Cancer Care Nova Scotia's provincial Genito-Urinary (GU) Cancer Site Team finalized a policy statement on the early detection of prostate cancer, developed at a consensus workshop in October 2001.
The statement says that the early detection of prostate cancer requires a partnership between Nova Scotia men and their physicians. Men need to be aware of prostate cancer and what it may mean for them. Those who have concerns about prostate cancer should discuss them with their doctor.
As well, physicians should discuss the potential benefits of early detection of prostate cancer with men over 50 and with men who are at higher risk. Men with a close relative (father, brother, uncle, grandfather) who has had prostate cancer or men of African heritage are considered to be at greater risk. If screening is to be performed in these men, it should begin at age 40. This is also an issue for men who don't know their family histories.
"Screening for prostate cancer remains a controversial issue," said Dr. Derek Wilke, co-chair, of the GU Cancer Site Team. "Screening may not reduce the number of deaths from this illness. Furthermore, the treatment for prostate cancer can cause other problems such as impotence and incontinence. For these and other reasons, we don't support screening men across the board."
There is no hard evidence that screening results in a decline in mortality rates. Since prostate cancer is a slow-growing tumour that occurs for the most part in older men, other illnesses may be present. A man may die of other causes before he would die of prostate cancer. For these reasons, physicians don't agree on the most appropriate age to begin screening.
"We think individuals and their doctors should decide on the best course of action," said Dr. Wilke. "As new evidence emerges, we will reconsider our position on screening."
Men of all ages who have the following symptoms should have a full urological examination including a prostate specific antigen (PSA) test and digital rectal examination (DRE): -- frequent, difficult or painful urination; -- dribbling urine; -- blood or pus in the urine; -- pain in the lower back, pelvic area or upper thighs; or -- painful ejaculation.
These could be signs of prostate cancer. Men found to have an abnormal prostate gland, even those with a normal PSA, should also have a full urological examination and should talk with a urologist.
The position statement on the early detection of prostate cancer reflects current evidence, clinical experience and input from those who attended the Prostate Cancer Consensus Workshop held in Halifax in October 2001. During the workshop, health professionals and representatives from community groups including prostate cancer support groups had the opportunity to review and discuss a draft position statement on early detection of prostate cancer. The GU Cancer Site Team carefully considered all input as it wrote the final version.
The Genito-Urinary Cancer Site Team is one of 13 cancer site teams established by Cancer Care Nova Scotia to develop clinical practice guidelines and standards of care. The guidelines and standards are to ensure that all Nova Scotians receive treatments that are based on the most up-to-date information.
Cancer site teams include oncologists, nurses, pharmacists, surgeons, dietiticians, social workers and others. They have a common interest and commitment to one kind of cancer or cancer site. Each team includes people from the cancer centres in Halifax and Sydney and from district cancer programs across the province.
Cancer Care Nova Scotia is a program of the Department of Health, created to reduce the burden of cancer on individuals, families and the health care system through prevention, screening, education and research.