Before I was diagnosed with prostate cancer, 16 years ago, my primary care doctor monitored my prostate health without my involvement.

Including the patient

I know that I started receiving my prostate specific antigen (PSA) test in my late 40s or early 50s, because I reviewed five years of PSA test results upon my diagnosis. Monitoring their patients’ prostate health was the standard practice of primary care doctors during that time, and men such as myself were notified if the doctor noticed a high PSA or physical abnormality.

Today, we have entered a new era of prostate health care where the phrases “talk with your doctor,” and “shared decision-making” are common guidance for patients.

“They’re waiting to see prostate cancer symptoms before ordering a test, and, to make matters worse, most men don’t know how to initiate this discussion.”

The source of confusion

There are so many confusing and controversial guidelines shaping prostate health care practice today that a patient could get lost. The 2012 recommendation by the U. S. Preventive Services Task Force against PSA testing for the early detection of prostate cancer is a strong impetus shaping prostate health care practice today. Other guidelines tell men to talk with their doctor about PSA testing at a certain age.

The problem is that many primary care doctors are not talking. Rather, they’re waiting to see prostate cancer symptoms before ordering a test, and, to make matters worse, most men don’t know how to initiate this discussion.

Recent data show a significant decrease in both PSA testing and the number of men being diagnosed with prostate cancer. However, doctors are reporting an increase in the number of men being diagnosed with aggressive and advanced cases of this disease. So is the patient actively participating in this health care decision-making process, or simply a bystander who will have to live with the outcome no matter how good or bad?

More precise solutions

Prostate health care is filled with many decision points, beginning with PSA testing. Should a patient face a prostate cancer diagnosis then there is the question as to whether or not they should be treated, the type of treatments, and how to manage survivorship issues. However, these are complex decisions that are highly dependent upon the individual patient.

We are witnessing many exciting breakthroughs in prostate cancer research and treatments. However, the patient has an integral and active role to perform successfully in this new era if the prostate cancer death rate is to continue its decline towards our ultimate goal of eliminating deaths from this disease.