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American Morning

Routine Prostate Screenings Necessary?

Aired December 03, 2002 - 08:44   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


BILL HEMMER, CNN ANCHOR: There is important health news this morning about prostate cancer that we are going to talk to. The second most deadly cancer among men. Now, a study questions the benefits of a testing for that.
Our medical correspondent, Dr. Sanjay Gupta, back here to sort it all out for us. Are we going to be confused or are we going to be straightened out here?

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: It's a little confusing. Let's try and work through this, though. It is a big topic, no question about it. The real question here, early detection of cancer. For the most part, the question is, does it lead to a longer life? Does it lead to a better life, that early detection? That's exactly the issue the United States Preventative Services task force looked into, and this is what they concluded.

Let's take a look at their conclusions here. You can actually hear, the evidence is insufficient at this time to recommend for or against routine screening for prostate cancer. That's a huge statement, that is an important statement.

For the first time, they are really saying that even though we have this early detection, we know that it works, we know that we can find prostate cancer early. Is that really translating to anything? Is it translating to the things that people really want: longer lives, better lives?

Prostate cancer is a slow-growing cancer. If you find it, if you treat it, biopsy it, all those sorts of things, do you end up living longer than you would have otherwise?

Because it is so slow growing, they conclude that maybe not. Maybe you would have died of something else anyways, and going through all of that, the treatment and all of that of the the prostate cancer, may not have provided you any benefit.

HEMMER: But as a doctor, though, if I'm a patient, mentality- wise, does it help me to know that if I have it or if I don't, if I am cleared or not?

GUPTA: That is an excellent point, and it is exactly the difference on why patients should be sort of counseled differently when it comes to prostate cancer differently. Some people -- they just want to know. Listen, do I have cancer in my body? I'm going to deal with that information once I have it. Some people will say, you know what, if it is not going to actually make me live any longer, or if it is not going to make me live any better, I'd just rather not know. Remember Bill, for a long time we didn't know about a lot of cancers that we know more about now, because we have these better screening tests, because we have screening tests like the PSA test, which has nodoubtedly increased the way that we detect prostate cancer.

HEMMER: So this study comes out and it throws everything up in the air right now. The balls are juggling right now. Let's say I still want to go get the test. Am I hurting myself, are there drawbacks to it?

GUPTA: The test itself is a simple blood test, for the most part. Just draw some blood, actually measure this prostate-specific antigen, that is what the PSA stands for. Above 10, that is a problem. Four to 10, you are in a little bit of borderline area.

The consequences of that information is where the problem lies. What are you going to do with it? Let's say you are a borderline guy. Let's say someone in your family is a borderline guy. Is he going to go get a biopsy? And then, if that biospy -- is that going to lead to an operation? And then the question that he and his entire family really asking themselves, did that operation actually lead to a longer life? Did it lead to a better life? The operation, the radiation treatment, the chemotherapy, that can lead to problem with incontinence, impotence, that can lead to bowel dysfunction. There can be some real serious consequences to the treatment, so there is a lot -- as you say, balls to juggle when you are thinking about this.

HEMMER: Listen, a lot of men over the age 50 are afflicted with this. What causes this type of cancer?

GUPTA: Well, you know, cancer itself, trying to figure out what causes it, is a complicated question. There are cells that turn things on, there are cells that turn things off. We can look at some of the risk factors, however, for prostate cancer. You can see them on the screen there, I won't read them for you. But basically, those are some of the risk factors. As you get older, you become increasingly at risk. People, as they get older, their prostate gives them more problems.

HEMMER: I need a yes or no answer here. Bottom line, should men get screened or not, based on the results of this survey?

GUPTA: Routinely screened, probably no. Talk to your doctor about screening. Make sure you understand -- when you get that information, what are you going to do with it? That is the key.

HEMMER: But you are my doctor.

GUPTA: We'll talk after the show.

HEMMER: Thanks, Sanjay. We'll see you later.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com






Aired December 3, 2002 - 08:44   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
BILL HEMMER, CNN ANCHOR: There is important health news this morning about prostate cancer that we are going to talk to. The second most deadly cancer among men. Now, a study questions the benefits of a testing for that.
Our medical correspondent, Dr. Sanjay Gupta, back here to sort it all out for us. Are we going to be confused or are we going to be straightened out here?

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: It's a little confusing. Let's try and work through this, though. It is a big topic, no question about it. The real question here, early detection of cancer. For the most part, the question is, does it lead to a longer life? Does it lead to a better life, that early detection? That's exactly the issue the United States Preventative Services task force looked into, and this is what they concluded.

Let's take a look at their conclusions here. You can actually hear, the evidence is insufficient at this time to recommend for or against routine screening for prostate cancer. That's a huge statement, that is an important statement.

For the first time, they are really saying that even though we have this early detection, we know that it works, we know that we can find prostate cancer early. Is that really translating to anything? Is it translating to the things that people really want: longer lives, better lives?

Prostate cancer is a slow-growing cancer. If you find it, if you treat it, biopsy it, all those sorts of things, do you end up living longer than you would have otherwise?

Because it is so slow growing, they conclude that maybe not. Maybe you would have died of something else anyways, and going through all of that, the treatment and all of that of the the prostate cancer, may not have provided you any benefit.

HEMMER: But as a doctor, though, if I'm a patient, mentality- wise, does it help me to know that if I have it or if I don't, if I am cleared or not?

GUPTA: That is an excellent point, and it is exactly the difference on why patients should be sort of counseled differently when it comes to prostate cancer differently. Some people -- they just want to know. Listen, do I have cancer in my body? I'm going to deal with that information once I have it. Some people will say, you know what, if it is not going to actually make me live any longer, or if it is not going to make me live any better, I'd just rather not know. Remember Bill, for a long time we didn't know about a lot of cancers that we know more about now, because we have these better screening tests, because we have screening tests like the PSA test, which has nodoubtedly increased the way that we detect prostate cancer.

HEMMER: So this study comes out and it throws everything up in the air right now. The balls are juggling right now. Let's say I still want to go get the test. Am I hurting myself, are there drawbacks to it?

GUPTA: The test itself is a simple blood test, for the most part. Just draw some blood, actually measure this prostate-specific antigen, that is what the PSA stands for. Above 10, that is a problem. Four to 10, you are in a little bit of borderline area.

The consequences of that information is where the problem lies. What are you going to do with it? Let's say you are a borderline guy. Let's say someone in your family is a borderline guy. Is he going to go get a biopsy? And then, if that biospy -- is that going to lead to an operation? And then the question that he and his entire family really asking themselves, did that operation actually lead to a longer life? Did it lead to a better life? The operation, the radiation treatment, the chemotherapy, that can lead to problem with incontinence, impotence, that can lead to bowel dysfunction. There can be some real serious consequences to the treatment, so there is a lot -- as you say, balls to juggle when you are thinking about this.

HEMMER: Listen, a lot of men over the age 50 are afflicted with this. What causes this type of cancer?

GUPTA: Well, you know, cancer itself, trying to figure out what causes it, is a complicated question. There are cells that turn things on, there are cells that turn things off. We can look at some of the risk factors, however, for prostate cancer. You can see them on the screen there, I won't read them for you. But basically, those are some of the risk factors. As you get older, you become increasingly at risk. People, as they get older, their prostate gives them more problems.

HEMMER: I need a yes or no answer here. Bottom line, should men get screened or not, based on the results of this survey?

GUPTA: Routinely screened, probably no. Talk to your doctor about screening. Make sure you understand -- when you get that information, what are you going to do with it? That is the key.

HEMMER: But you are my doctor.

GUPTA: We'll talk after the show.

HEMMER: Thanks, Sanjay. We'll see you later.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com