James Eastham on PSA testing and prostate cancer risk


Dr. James Eastham is a highly respected and specialized prostate cancer surgeon who works at the Memorial Sloan-Kettering Cancer Center in New York City. In an interview just published on the OncologySTAT web site, he talks about his views on the appropriate application of the PSA test today in assessment of risk for prostate cancer and management of low-risk disease.

Access to the OncologySTAT web site is free, but you do have to sign up to belong to the site.

Dr. Eastham, like The “New” Prostate Cancer InfoLink, discriminates very carefully between mass screening of all men on an annual basis, and careful identification and regular testing of those men who are clearly at heightened risk for prostate cancer. Also like The “New” Prostate Cancer InfoLink, he appears to clearly understand both why the U.S. Preventive Services Task Force came to and made the recommendation it has issued and the fact that, for men at heightened risk for clinically significant prostate cancer, a blanket, mindless acceptance of that recommendation is about as smart as going swimming with Great White sharks while bleeding from an open wound.

We stated in yesterday morning’s post that we believe that the AUA is being encouraged to modify its recommendations about the use of the PSA test by a “new generation” of opinion leaders. It is clear to us that Dr. Eastham is one of those who is fully behind a more careful and selective application of PSA testing in the greatest interests of those who need early diagnosis and of those who need to avoid risk for over-diagnosis and over-treatment.

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