As we recognize Prostate Cancer Awareness Month this year, the fight against prostate cancer is at a critical crossroads.

In the USA, prostate cancer is the leading type of cancer among men with over 220,000 cases and 30,000 deaths annually. Since I was diagnosed with the disease fifteen years ago, its death rate has declined by 40 percent, a cause for celebration—you would think. Most prostate cancer medical experts attribute this decline to early detection through PSA testing.

Losing momentum

In 2012 however, the U. S. Preventive Services Task Force (USPSTF) without a single prostate cancer medical expert as a member recommended against PSA testing. While the major cancer organizations' prostate cancer early detection guidelines contradict the USPSTF's recommendation, primary care doctors and federal government polices rely almost exclusively on it. This clash in medical guidance defines the crossroads.

"Prostate cancer patients and men who need to know their prostate health want and deserve clarity, and an end to conflicting early detection guidance."

The USPSTF's negative recommendation included men at the highest risk for prostate cancer though they were not represented at a statistically significant level in the data it used. African American men with prostate cancer incidence and death rates 1.6 and 2.5 times higher, respectively, than for all other men lead this high risk group. Many consider the USPSTF’s position an abandonment of this population.

Today primary care doctors, the first line of defense against prostate cancer, are advised not to give the PSA test thus disregarding the benefits of early detection for the disease regardless of a man's risk level. Prostate cancer medical experts say this will turn the clock backwards to when a much greater number of men were diagnosed with late stage incurable cancer—a staggering setback.

New tests

Prostate cancer research efforts have made tremendous progress during this controversy. There are now genomic biomarker tests to help doctors determine: if a biopsy is needed; whether treatment or active surveillance is the proper course; if cancer is present with a negative biopsy; if additional treatment is needed following surgery. And more breakthroughs are on the way. While these tests do not replace the PSA test they do address many of the major concerns outlined by the USPSTF when issuing its negative recommendation in 2012.

Prostate cancer patients and men who need to know their prostate health want and deserve clarity, and an end to conflicting early detection guidance. Our goal is balanced medical care that saves lives while protecting from unnecessary treatments.

With new biomarker tests, new treatments for advanced stage cancer and progress towards personalized treatments, there is growing optimism about winning the fight against prostate cancer. However, there is a glaring need for heightened public awareness and support of prostate cancer issues, along with strong leadership by public officials to move beyond the current crossroads and keep the fight on course.