My thoughts-
The interesting thing about this article has to do with something that happened to me about a month ago. I have been treating an elderly male for symptoms of an enlarged prostate. He was on two medicines for that and was getting along quite well. I had examined his prostate about two years ago, he was 82 at the time, and it was mildly asymmetrical but for his age unremarkable. He, a friend of his, and I all agreed that because of his age and other medical problems that we would stop getting PSA’s and doing rectal exams. Recently he was in the hospital for a heart condition and on chest xray was noted to have an abnormality of his ribs. This prompted
a bone scan revealing wide spread metastatic bone disease. A PSA was obtained by the cardiologist and the value was over 1300. His daughter calls me to tell me that her father that has been under the care of a “urologist” for two years has widespread metastatic prostate cancer. So. These studies and others that you may read that may regard to other various medical topics have to be taken with a grain of salt. I personally will continue do rectals and occasional PSA’s on my older healthy patients. I can quote all the studies I want to this family, but they feel that I allowed prostate cancer to progress in a loved one under my care. This type of stuff happens all the time in medicine and again showing why the practice of medicine, “is an art and not a science.”
Prostate Diaries 