The Mount Sinai Medical Center Prostate Cancer Expert Dr. David B. Samadi, MD Discusses Study Supporting Prostate Cancer Screening for High Risk Men

   September 22, 2010   

NEW YORK, Sept. 22

According to a study from Britain’s Institute of Cancer Research (ICR) and Royal Marsden hospital, men at high-risk for prostate cancer would best benefit from early screening. A long-time proponent of early prostate cancer screening, Dr. David B. Samadi, Chief of Robotics and Minimally Invasive Surgery at the Mount Sinai Medical Center in New York City, has routinely recommended a frequent PSA test in men over 50, sometimes as early as age 40, based on risk factors. Dr. Samadi, a robotic surgery expert with over 3,000 successful prostatectomy surgeries to his credit, said the study’s findings puts more focus on men whose genes classify them at high risk, thereby increasing the chances that cancers would be caught earlier, as well as minimizing the incidence of costly “over-diagnosis” and unnecessary prostate cancer treatments.

“I have always believed that being proactive and diagnosing the disease earlier than later is better than active surveillance, or watchful waiting, which could end up being very expensive in both cost and life,” said Dr. Samadi. The study proved that prostate cancer screening is “reasonably accurate at predicting potentially aggressive prostate cancer” among high-risk men who have a genetic predisposition to the disease. The predictive value of screening was found to be 48 percent, which was remarkably higher than 24% percent found in screening men in general population.

“This is a far cry from last year’s study in the United States which found that routine prostate cancer screening had resulted in more than a million ‘over-diagnosed’ cases,” said Dr. Samadi. Over-diagnosed cases are due to controversial prostate-specific antigen (PSA) tests which can not distinguish between men with aggressive cancer and men who may have never had symptoms or needed treatment. Over-diagnosis can result in needless surgery, radiation or hormone therapy that result in serious side effects such as impotence and incontinence. Such incidences have discouraged many countries, like in Europe, from adopting a nationwide screening drive.

However, the British study demonstrates increasing evidence that heritable mutations in the genes BRCA1 and BRCA develop more aggressive disease. These findings support the recommendation that men who predisposed to these genetic factors be routinely screened for prostate cancer. “These genetic mutations are not common but they can have a major impact, because the BRCA2 mutation increases risk by up to seven times, while a BRCA1 mutation has been known to double the risk of prostate cancer in men under the age of 65,” said Dr. Samadi, a robotic surgery expert, who is also trained in laparoscopy and traditional open surgery.

“Early detection and treatment provide the greatest chance of prostate cancer cure and reduced side effects like impotence or incontinence,” continued Dr. Samadi. “Prostate cancer is the second leading killer of American men, and will affect one in six in this country, which is why detecting it early is key, and can provide up to a 95% cure rate.”

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