A roach in the ointment

bugsSo, your house has a roach problem.

You’ve tried spraying, stomping, and bombing. You even invite your filthy guests to a night in the sticky Roach Motel, only to find they prefer the accommodations beneath your kitchen cabinet. You’re at your wit’s end when you read about a magic solution.

Ignore them. I mean, most of the roaches are small. They won’t hurt you. So, just stop looking at them.

That’s basically what the U.S. Preventative Task Force told us about prostate cancer in 2012. Prostate cancer screenings, a task force study told us, are more harmful than beneficial. The majority of men with prostate cancer have low-aggressive forms that don’t need treatment. Routine screenings, the task force concluded, only scare men into treatment that comes with embarrassing and even painful side effects.

The task force is afraid you’ll use a hand grenade to kill the roaches.

Some urologists applaud the study, telling us it will save men a lot of stress and harm. Others warn that it will lead to more prostate cancer deaths.

Now comes a study, four years later, that asserts the cases of aggressive prostate cancer are on the rise.

While you weren’t looking, the roaches were getting bigger and stronger.

Researchers involved in this recent study found that the number of cases where cancer spread beyond the prostate have doubled in men age 55 to 69 since 2004. The disease is becoming more aggressive, researchers concluded, or…

wait for it…

“The other idea is since screening guidelines have become more lax, when men do get diagnosed, it’s at a more advanced state of disease,” says Dr. Edward Schaeffer, the urologist who chaired the study.

In other words, either the roaches are getting stronger, or since you weren’t looking, they were allowed to spread beyond your kitchen cabinet. They’re living under your rug, inside your dresser drawers, and under the mattress of the baby’s crib.

Disturbingly, there seems to be little doubt that fewer men are subjecting themselves to routine screenings. Two separate studies found that the number of prostate cancer screenings fell as much as 18% after the U.S. Preventative Task Force ruled that a pound of prevention was simply too heavy. Of course, with fewer screenings, the number of prostate cancer cases dropped.

Dr. Otis Brawley of the American Cancer Society was quick to debunk the study that suggests prostate cancer is getting more aggressive.

“Epidemiologists learned long ago that you can’t simply look at raw numbers,” says Dr. Brawley. “A rising number of cases can be due simply to a growing and aging population among other factors.”

That’s right, Dr. Brawley. You have to look at more than just raw numbers. You need to look into the faces of people like my father, who suffered and withered when a doctor failed to take seriously the elevated numbers from his prostate cancer screening. You need to look at the children whose father was discouraged away from the screening that would have told him there was a killer silently growing in his body. You need to look at the data from the American Cancer Society, your own organization, that predicts 26,120 men will die from prostate cancer this year.

“Prostate cancer screening is certainly not perfect,” says Dr. David Penson, urologist at Vanderbilt University. “It doesn’t mean we should throw the baby out with the bathwater. If your loved one died because there was no screening, that makes a big difference to you.”

It makes a huge difference to me.

Screening must come with education. It’s not enough to look beneath the kitchen cabinet, you must know how to evict the roaches if you find them there. But you have to look. There might be nothing. There might be a single baby cockroach who starves all on its own. Or there might be a strong, hungry swarm preparing to spread quietly through the walls.

How do you know they’re there unless you look.

Otherwise, you let the roaches win.



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