The Chief Medical and Scientific Officer of the American Cancer Society, Dr.Otis Webb Brawley, was recently reported to be at the receiving end of criticism for openly expressing his skepticism over the use of routine PSA screening for detection of early prostate cancer. The test approved by the FDA, provides elevated prostate specific antigen readings indicative of presence of prostate cancer. However, the test, though routinely prescribed, has not significantly reduced number of deaths due to prostate cancer, rendering the value of PSA screening questionable.
Dr. Otis Webb Brawley
Otis Brawley is the CMO and Executive Vice President of the American Cancer Society. He is the public face of the cancer establishment. He shoulders responsibility of promotion of cancer prevention goals, cancer related research and education, cancer support groups, early detection of cancer and puts in efforts to promote and enhance community cancer control efforts wherever applicable. He is a global leader in the field of health disparities research. Dr. Brawley presently serves as professor of medicine, oncology, hematology, and epidemiology at the Emory University. He also holds office as a member of the Centers for Disease Control and Prevention, Breast and Cervical Cancer Early Detection and Control Advisory Committee. Castle Connelly lists Dr. Brawley as one of America’s top doctors for cancer.
Dr. Brawley’s Take On Routine PSA Screening for Early Detection of Prostate Cancer
Dr. Brawley and other physicians, who agree with him, claim that, routine PSA screening may do more harm than good by leading healthy men to undergo unnecessary testings, examinations, and treatments that can increase their sufferings and even lead to their death. This observation when supported with studies claiming no significant changes in death rate due to PSA screening reveals the futility of the PSA test.
Dr. Brawley explains that PSA screening would just lead to detection of ‘huge reservoir of indolent cancers’, which would require to be treated with surgery. Surgical intervention would include removal of prostate gland and this is a tricky job even for the most skilled and experienced of surgeons. The likelihood of the urethra and erection initiating nerve bundles being damaged is high in such surgeries. Impotence and incontinence are common side effects for patients undergoing surgery or radiation therapy for prostate cancer.
Thus, knowledge of the presence of prostate cancer, which for majority of patients grows slowly and does not harm the host, may prove to be more disastrous for the patients than not knowing it . Dr. Brawley himself, has declined PSA screening and believes that the “Test may cause more harm than good”.
Dr. Brawley believes that the greatest concern and disappointment over PSA screening is that it has led to a slow down and proved to be a distraction on prostate cancer research. The time could have been utilized to research new methods and treatments that can bring down the number of deaths by differentiating between prostate tumors that should be removed from those that are best left alone.
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