Men should be warned of possible distress of prostate cancer testing

British Journal of Cancer

Doctors should warn men that prostate cancer testing may lead to anxiety and distress, say Cancer Research UK experts.

While most men cope well, one in five can feel distressed at the prospect of having a biopsy after discovering they have a raised PSA level.

And nine per cent continue to feel this way even after being told they don’t have cancer, according to the study published in the British Journal of Cancer.

The researchers are calling for the psychological effects of testing to be clearly explained to men who ask for a PSA test.

Professor Kavita Vedhara, lead author on the study which was conducted from the University of Bristol, said: “At the moment, doctors are asked to warn men about the difficulties of interpreting the results of a PSA test. The test misses some cases and can produce false alarms.

“While it’s crucial that men are aware of the difficulties they may face when deciding what to do with their results, it’s also important they’re aware that they may find the whole process stressful.

“We also found that in some men, the psychological effects lasted even after the men were told their biopsy was benign.

“Even 12 weeks after receiving a negative biopsy result, nine per cent of men said they still felt distressed.

“It’s essential that doctors know about this, and that men are fully informed of the psychological challenges they may face during and after a PSA test.”

High PSA levels may signal prostate cancer, but the protein may also be raised by infection, a non-cancerous enlarged prostate or even recent exercise.

PSA testing is not routinely offered in the UK, but men can discuss the risks and benefits with their doctor if they are concerned that they may have prostate cancer.

Up to 70 per cent of men receive a negative biopsy result following a raised PSA level.

In this study, 330 men aged 50 to 69 were surveyed throughout the test for prostate cancer as a part of a Cancer Research UK funded study. This study is linked to the ProtecT trial1, which is investigating the best ways to detect and treat prostate cancer.

Martin Ledwick, head cancer information nurse at Cancer Research UK, said: “For some men detecting prostate cancer early may be life-saving. However, the test will be abnormal for around one man in eight without cancer being detectable at that time.

“Further tests and biopsies are usually needed to rule out cancer for these men. This study shows just how important it is that men in their 50s and 60s can talk to their doctor about the pros and cons of having a PSA test and only have the test if they feel it is right for them.”

ENDS

For media enquiries please contact the Cancer Research UK press office on 020 7061 8300 or, out-of-hours, the duty press officer on 07050 264 059.

References

  • Macefield, R. et al (2010). Impact of prostate cancer testing: an evaluation of the emotional consequences of a negative biopsy result British Journal of Cancer DOI: 10.1038/sj.bjc.6605648

Notes to Editor

  1. Funded by the National Institute for Health Research Health Technology Assessment Programme.