Prostate Cancer Decision-Making, Health Services, and the Family Physician Workforce

Abstract

Untreated cancer equals death? This is the underlying fear and myth that drives many patients. However, there is the corresponding assumption than an unfound cancer is not a deadly cancer and a found cancer is a deadly cancer. With prostate cancer screening, we would argue, the main issue is not the prostate-specific antigen test itself, certainly an imperfect test, but what happens afterward. Having a lower level of prostate-specific antigen does not require immediate treatment. This is not a myth, but it is very difficult concept for patients and physicians. Once men know the cancer is actually present (as compared with the large number of men whom have prostate cancer but do not know it), they struggle to decide to watch and wait. For those who consider watchful waiting, significant others and physicians often pushed toward active treatment. Read some of the telling comments in Xu et al.