Buffett’s prostate cancer “shouldn’t lead all men in their 80s to get screened for PSA”

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Some reactions to the announcement that Berkshire Hathaway Inc. Chairman Warren Buffett was diagnosed with early-stage prostate cancer diagnosis were a little out of control.

CNBC, for example, posted a piece entitled, “Buffett’s Cancer Scare Has Doug Kass Rethinking Berkshire.”  Kass is a strategic investor.  A stage one prostate cancer in a man Buffett’s age should hardly be called a “scare” nor something that should lead investors to rethink their financial strategy.

Cooler heads prevailed, for the most part. On the Wall Street Journal Health Blog, Ron Winslow wrote:

“…at his age, “a substantial number of men may not need treatment,” says Peter Carroll, chief of urology at University of California, San Francisco.  Rather than risk potential side effects, including incontinence and impotence for some treatments, they opt for “active surveillance” to monitor their tumor for evidence that a more aggressive approach is necessary.

For those choosing treatment, says Jonathan Wright, urologist at University of Washington and the Seattle Cancer Care Alliance, surgery to remove the prostate and the type of radiation Buffett will get are equally effective in curing early stage disease, though men of Buffett’s age typically  lean against surgery. “The prognosis for Mr. Buffett is excellent,” he says.

But people who swear by Buffett’s investment strategy may want to think carefully before following his course on prostate care. Indeed, his case raises anew the controversy over the value of PSA testing, UCSF’s Carroll tells the Blog.  While not questioning Buffett’s decision, he says “some men when they (reach age 65) and their PSAs are low, they may not benefit from testing.”  Some question the value in younger men.

Early diagnosis can lead to over-detection and over-treatment of disease that will never cause any problems. “The message from [Buffett’s diagnosis] shouldn’t be that all men in their 80s get screened for PSA,” Carroll says.

Addendum later on April 18:

On the NPR Shots blog, Scott Hensley interviews a urologist who says he’d fire any resident who biopsied the prostate of an 81-year old man.

 

 

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