Two years ago I wrote about the controversy of routine screening for prostate cancer. Screening for prostate cancer is usually done with a blood test called PSA. But whether diagnosing prostate cancer early helps patients is still unknown, and there are many serious complications that result from prostate cancer treatment. That’s why in many cases of prostate cancer watchful waiting is a reasonable choice.
The U.S. Preventive Services Task Force recently reviewed the existing evidence for and against prostate cancer screening and published their recommendations in this week’s Annals of Internal Medicine. Their findings drew much media attention.
The new USPSTF recommendations still state that there is insufficient evidence to recommend for or against screening for prostate cancer in men 50 to 75. But the recommendations recommend against screening for prostate cancer in men 75 and older.
There are ongoing studies now that will answer definitively whether diagnosing prostate cancer early helps. Until those results are available, men over 75 should review these recommendations and discuss them with their doctor before making a decision about whether to have a PSA. The test may lead to much more harm than benefit.
Washington Post article: U.S. Panel Questions Prostate Screening
Last week’s post, The Exercise Transformation, elicited many responses.
Three readers suggested that being accountable to someone else is the key to making exercise a habit. To that end, they recommended hiring a personal trainer, so that each episode of exercise is an appointment with someone else and is therefore harder to postpone or cancel.
Two readers thought that recommending 30 minutes of exercise on most days is a very intimidating goal for someone sedentary, and that success would be more likely to be achieved with a less ambitious initial goal, for example 10 minutes three times a week. Once this easier schedule becomes a habit, the duration and frequency can slowly be increased.
My only disagreement with that reasonable suggestion is that I’ve had several patients tell me that the only way to make something a habit is to do it almost every day. Even though the cardiovascular benefits of exercise only require 30 minutes of exercise three times a week, this may be harder to sustain psychologically than a daily habit. Ultimately, I would recommend whatever works for each person. If doing something every day seems like an insurmountable initial goal, start slower.
Finally, a reader wrote to extol the power of just showing up. She said that when she doesn’t feel like exercising, she talks herself into it by just putting on the swimsuit and getting to the pool. Once there, the actual swim doesn’t seem as daunting.
I’m grateful to everyone who emailed.