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Safer diagnosis of prostate cancer to alleviate the suffering

Over 10,000 Swedish men get each year a prostate cancer diagnosis. It is the most common form of cancer in Sweden. Approximately 100,000 Swedish men diagnosed with – and die each year is 2,400 men in the disease.

in Order to bring down the mortality rate in prostate cancer, it is important with early detection. Nevertheless, there have not been any organized prostatatestning. Instead, it is up to each man to take the initiative and decide if you want to test or not.

But now is a significant improvement of the prostatacancerdiagnostiken in Sweden at the time, says Ola Bratt, professor and chief physician in urology at the Sahlgrenska university hospital in Gothenburg, sweden.

" I would say that we are facing a paradigm shift. Several regions are now taking forward plans for an organised, informed and targeted diagnostics that will greatly reduce the severity of the current model. In addition, this will lead to the reduction of morbidity and mortality in prostate cancer, " says Ola Bratt.

Read more: Screening for prostate cancer can reduce deaths by 30 percent

An important aspect is also that with an organized testing will have the knowledge of how the diagnostic methods should be improved to increase, " he says.

there is new knowledge in the area of Ola Bratt highlights.

• Nearly half of all men, those with low values at the prostataprovtagning, can be tested very rarely, and finish the testing in the 60s.

• Additional blood tests in combination with mr, MR, can identify the men who in spite of increased PSA values (prostate specific antigen) has a low risk of prostate cancer in the long term. These men do not need to undergo tissue sample, called a biopsy.

• In case of tissue sample needed make MR. that the sampling can be directed toward suspicious areas in the prostate.

with prostate cancer for almost 30 years, and considers himself as ”a nerd” in the area. Expert, perhaps others would say.

He says that prostatacancerdiagnostiken over the last few decades have gone from the one extreme to the other. From having been dominated by underdiagnostik of serious cancer that is dominated by överdiagnostik where natured prostate cancer are treated unnecessarily.

Ola Bratt, professor and chief physician in urology. Photo: Emelie Ljunggren

He does not mince words about how it worked, saying, " we within a few years, with shame, will look back at the past years model for prostate cancer diagnosis method and the treatment that followed in its wake.

– most of these men operated on unnecessarily had never noticed of their prostate cancer before they died of something else, " he says.

in the beginning of 90-ies were detected prostate cancer usually only when it was too late. Now you can detect the cancer in time. But because the test does not distinguish between the more modest and aggressive cancer has many men had surgery, but that it needed – and then suffered side effects like urinary leakage and impotence.

– More than 50,000 Swedish men has in recent decades received a diagnosis of cancer unnecessarily, " says Ola Bratt.

Read more: the Mortality rate of cancer reduced

Among other things, why has the health Board so far said no to general screening for prostate cancer. Instead it has called on the regions to try and improve the prostatadiagnostiken. It is the work now begins in several regions.

for the national Board of sakkunniggrupp for prostate cancer screening. He says that the Board's decision to not recommend a national screening program based on comparisons between general screening and no PSA-testing of symptom-free men.

Also mammography provides överdiagnostik, but not nearly as extensive as in prostate cancer.

" They took not take into account that over two-thirds of all Swedish men PSA tested in the present. This is completely unorganized, which makes testing both the unequal, inefficient and very resource intensive. The relationship between the damage överdiagnostik and treatment and the benefit is significantly worse in the unorganised than in the organised testing which is based on callings and to a predetermined flow for the handling of test results, " says Ola Bratt.

– in Addition, the unorganised testing to increase knowledge about how the diagnostic methods should be improved.

for many years made regular mammograms of women between 40 and 75 years in Sweden, the so-called screening, in order to detect cancer early.

– Although mammography provides överdiagnostik, but not nearly as extensive as in prostate cancer, " says Ola Bratt.

the Problem with prostatacancerdiagnostiken, according to Ola Bratt, was used as a nonspecific marker, PSA test, which just tells you that it is a disease anywhere in the prostate – not the and was not in the gland.

– Therefore, we have routinely been taking a ”burst” of tissue samples throughout the prostate. It is these ”systematic biopsy” that is the culprit, because they often accidentally detect a frivolous cancer. This method is nothing to be proud of, " says Ola Bratt.

Read more about cancer

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