The debate about the U.S. Preventative Services Task Force giving the PSA test a “D” rating was all over the morning talk shows today. But perhaps the most interesting debate happened during a commercial break. While this clip did not air, CBS fortunately recorded it.
Watch as Dr. Otis Brawley, Chief Medical Officer of the American Cancer Society, and former basketball coach Digger Phelps, who has had surgery for prostate cancer clearly articulate the two opposing poles of the PSA test.
Hat/Tip to HealthNewsReview for blogging the video.
Near the end, Phelps passionately argues against “watchful waiting,” saying the idea of having cancer is too frightening to postpone treatment. Brawley starts to make the case for informed consent, but doesn’t have time to finish in this clip.
But this is exactly the paradox of going ahead and doing the test. Brawley estimates a million men have been needlessly cured of their prostate cancer– a disease men are significantly more likely to die with and not from.
This is what’s behind the U.S. Preventive Services Task Force recommendation: if you can’t live with doing nothing in the face of a prostate cancer diagnosis, then don’t have the PSA test in the first place. You are more likely to be harmed by the treatment–the harms range from incontinence, impotence and death.