New prostate cancer screening guidelines issued

I want to tell you about a story that we are following, and this is something that I think grabbed a lot of people's attention yesterday. So we obviously know that a simple blood test can help find prostate cancer before it spreads. And this week, the American Cancer Society is now changing its recommendations on when men should get screened and how often. So joining us now is Dr. William Dehut, the society's chief scientific officer. Doctor, I appreciate you joining us this morning to be able to break all this down for us. Yeah. Happy to be on. So let's start here. What are the new recommendations? I know 45 years old. If you have some family history, what can you tell us? Well, I think first of all, it's important to know that the recommendations have actually changed fairly significantly. This is actually the first time in recent memory that we're actually recommending that men are screened for prostate cancer with a blood test called the PSA test. So if you're at average risk, you should be screened every two years between ages of 50 to 69. If you're at high risk, which means you have a first-degree relative, That has prostate cancer or you're a black man, then your screening begins at age 45 and whether it's every year or every other year depends a little bit on if you're at high risk as whether or not you have a first degree relative before or after the age of 65. Now, once you hit age 70, between age 70 to 74, the benefits and harms become much more balanced. And at that point, we really have individualized decision making, where you really need to talk to your doctor, whether it's right for you. And really, most people should really stop at that point. But there are a few exceptions. We know some men may want to be screened a little bit longer, between 75 and 79. Again, and it's individualized. But really, at age 80, everyone should stop screening. So what changed here? I mean, this is the first time in years that you guys have changed the recommendation for screening. Why now? And what was the purpose behind it? So really, two things are really important that have changed. As we come up with any sort of screening guidelines, what we want to look at, are there clear benefits of benefit? And how do we mitigate harm? And over the last 16 years, since our last guideline, there is now clear evidence of benefit. There's now randomized, large, controlled studies with hundreds of thousands of subjects over two decades, which shows that if you screen for prostate cancer using a PSA test, you'll be less likely to be diagnosed with metastatic cancer, and you'll be less likely to die from the disease. But as you know, there are many men who have a prostate cancer diagnosis, which will not actually die from the disease or ever have symptoms. So we've done some things to mitigate that. First of all, we've said if you have an elevated blood test, the PSA test, have it repeated before you do anything else. Within a couple of weeks or maybe a couple of months, that's the first step. And then prior to going on to a biopsy, you need a secondary test, whether that's an MRI, actually an imaging of the prostate, or maybe a validated biomarker. There's not an MRI easily available. If that's abnormal, then you go to a prostate biopsy. It's usually a fused biopsy with an image of an MRI, so the physician can see the exact area that's abnormal. And even if you have a cancer diagnosis, we know many men now with very early stage, early grade disease can be very safely followed, followed intensely. They're not forgotten. So whether you have MRIs and PSAs, maybe another biopsy. And if we see then a change in the cancer, at that point, you intervene. So by doing these things, we can minimize harm. Not over treating folks. And then also there's clear evidence of benefit. And so what does a PSA test actually involve? And is it something that you actually need to specifically request? Well, I think that you should really be informed about the risks and benefit of any test. So we're not really a fan of folks just having it added on to the routine blood work. But if you're getting routine blood work with your physician, it's very easy to add it on as part of it. It can be done essentially in any clinical I'm going to go to the clinical laboratory. And results come back relatively quickly. You can always have some variation in a blood test that has actually a number given to you. And that's why we recommended the test being repeated before you actually take action. And an elevated PSA test does not mean you have cancer. PSA is made by normal cells as well as cancer cells. So if you have a big prostate, and prostates can enlarge over time, if you have an infection or inflammation, you can see an increase in the PSA level that is unrelated to cancer. And so what happens if someone feels perfectly healthy, has no symptoms, why should they still consider getting screening if they fall within the new age recommendations? Well, I think, first of all, almost everyone who is screened for a cancer is someone who really should be having no symptoms. Because if you have a symptom, that needs a very directed workup. But the big thing we know in prostate cancer, if you find it early on and have the information about really the biology of your cancer, you can either treat it right away and your outcomes are much better. Nearly 100% of people who have a prostate cancer diagnosis with with an early stage disease, are alive at five years. And if you find a... Early cancer and early stage cancer, maybe we can watch it over time. What we don't want is what we've seen is unfortunately we're seeing a greater percentages of men who are not been screened or not screened frequently presenting later on with more advanced cancer. Many of those are incurable. Many of those have more intensive therapies, which include lowering of men's testosterone and potentially even chemotherapy. And just before we go, one final question, just quickly, what would you tell people watching right now who are listening to this conversation? What's the one thing you want them to know and take away from this? So if you're in the age group, if you're at normal risk between 50 and 69, or if you're at high risk between 45 and 49, talk to your physician, let them know we're recommending prostate cancer screening and determine whether it's right for you. Well, doctor, I really appreciate you joining us. Obviously, very important news coming from the American Cancer Society this week that everyone really needs to listen to. Obviously, always the best recommendation, talk to your doctor. Dr. DeHutt, I appreciate you joining us this morning. Yeah, thanks a lot. Take care.