The Roswell Park Cancer Institute in Buffalo has a reputation as one of the finest cancer care facilities in the country.
But their promotion of prostate cancer screening doesn't match that reputation.
They've created a Prostate Club For Men.
On their website, they trot out tired old lines that fail to give the whole story about prostate cancer screening:
When it comes to prostate cancer, early detection saves lives. In fact, around 90% of prostate cancers found at an early stage are cured. Men - and the women who love them - need to be proactive in understanding the risk factors and how to 'aim for a cure' through early detection.
That's what the Prostate Club is all about. As a Club member, you will be making a commitment to discuss screening with your doctor, and, if deemed appropriate for you, have both a PSA test and digital rectal exam (DRE). It's quick and simple, and it could save your life.
There should be nothing "quick and simple" about the decision to pursue prostate cancer screening. The American Cancer Society and others urge that:
"men should have an opportunity to learn about the benefits and limitations of testing for the detection and treatment of early prostate cancer. ...At the center of the uncertainty concerning the balance of benefits and harms related to testing for early prostate cancer detection is the fact that treatment for prostate cancer can cause moderate to substantial harms, including erectile dysfunction, urinary incontinence, bowel dysfunction, and death. Although some prostate cancers are aggressive and lifethreatening, others grow so slowly that they may never produce symptoms, or may not progress to a point at which they are life-threatening before a man dies from other causes. Because aggressive therapy can measurably reduce a patient's quality of life, there are serious and yet unanswered questions regarding the balance of benefits to harm related to the treatment of screen-detected disease when that disease may be indolent or so slow-growing that it may pose a low risk of death."
Will members of The Club be told all of this? It doesn't appear on their website.
Instead, men are lured in by offers of prizes like hockey tickets IF they commit to discuss screening. And there are no rules about ages of men who are eligible. The site says that "age 50 has traditionally been the age for starting to consider PSA testing," but that others are now urging men to have a baseline test as early as age 40. There's no mention of how controversial those earlier screening recommendations are. Just the pitch, "If you've hit the age of 40, you need to join the Prostate Club for Men."
Then there's the website's advocacy message from Scott Levin, WGRZ-TV Anchor:
"As the evening anchorman for WGRZ-TV 2 in Buffalo for the last 12 years, it's my job to inform the viewers of Western New York. To me, informing our viewers of the latest health news is of utmost importance. ...
Our goal is to have men get screened for prostate cancer. By the way, it's very easy to do... it only takes seconds to get checked and it's totally painless! I get screened every year during my birthday week. Booking my doctor's appointment the week of my birthday helps me to remember to do it yearly, and it's a birthday present not only to myself, but to my family as well.
...It's about time men learn how easy it is to get screened for prostate cancer--early detection is the key to your success!"
Not one word about controversy, about uncertainty, about the harms of screening, about the importance of careful shared decision-making discussions to weigh the potential harms along with the potential benefits.
And about the potential benefits and harms, and about such screening promotions, I urge the promoters of this Club, and the TV anchor, to read the editorial by American Cancer Society chief medical officer Dr. Otis Brawley in the Journal of the National Cancer Institute. Excerpts:
"As I sat down to write this editorial, I heard a radio commercial that brings perspective to the issue. A local celebrity was promoting prostate cancer awareness. He said, "Prostate cancer is 100% curable when caught early." He encouraged all men to get screened and announced that a van was touring the area offering screening in supermarket parking lots. This was a community service project sponsored by the radio station, the supermarket chain, and a radiation oncology practice.
A commercial like this plays to our fears and prejudices. ...
Prostate cancer screening has resulted in substantial overdiagnosis and in unnecessary treatment. It may have saved relatively few lives. ... The benefits of prostate cancer screening are still open to question. This means that informed or shared decision making should be done using the data now available before screening is performed. Some of the confusion of prostate cancer screening can be avoided if we all clearly label what we know, as what we know; what we do not know, as what we do not know; and what we believe, as what we believe. Of course, one must not confuse what is believed with what is known to do this."
Those weren't my words, but the words of the chief medical officer of the American Cancer Society. Gee, do you think this editorial should be put on the website of The Prostate Club For Men?