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CNN Live Event/Special

Blood Test For Prostate Cancer Grossly Inefficient

Aired July 24, 2003 - 19:36   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


COOPER: All right, well, a common test for prostate cancer, which kills 29,000 men a year, may not be as accurate as previously thought. A new study says the prostate-specific antigen blood test, also called a PSA test, that's how you probably know of it, fails to detect, get this, 82 percent of tumors in men under 60, 82 percent. For older men, 65 percent of cases reportedly go undiagnosed.
Now, some potentially alarming news, certainly. What does this study mean, exactly?

Dr. Len Lichtenfeld is deputy chief medical officer for the American Cancer Society. He joins us tonight from Atlanta.

Doctor, thanks for being with us.

I got to tell you, when I first read the study, I mean, it sounds incredibly alarming, 82 percent of these cases go undiagnosed in people under 60. Is it that bad?

DR. LEN LICHTENFELD, DEPUTY CHIEF MEDICAL OFFICER, AMERICAN CANCER SOCIETY: Anderson, it does sound alarming, and I don't think it's as bad as it sounds. What this study does -- and I might point out that this is a study of numbers, not a study necessarily of large numbers of people. What the study suggests is that if we biopsied more men with lower values, we'd find more prostate cancer.

Actually, that's not new information. We've always known that. And what the study also does is perhaps add more confusion around prostate cancer, both with respect to what we need to do to diagnose it early, and whether or not diagnosing it early really makes a difference in the outcomes, in the survival and the quality of life for those men where we do make that diagnosis.

COOPER: Well, now, I've always understood that if you get this PSA test and it's above 4, then perhaps you should get it biopsied. But basically, what the people who are behind this test say is, actually that number should be lower. If you get a PSA reading, I think, around 2.6 or above, then you should maybe think about biopsies. I mean, what, where, what the advice here?

LICHTENFELD: Well, let's understand, Anderson, that in reality, that four -- that number of four has only been a relative number. We've always known that younger men have very low values, and that if we follow that value, and suddenly it goes up, for example, from zero to 2.5 or to 3, then perhaps we should be concerned and consider biopsy. There were -- the 4.0 number or the 4.1 number is not absolute. It's relative. And let's not also forget that there are a lot of men who have a value over 4 that they don't have prostate cancer. All they have are enlarged prostates.

Even saying that, there are a lot of men with prostate cancer where we now know it will not make any difference in their lives if we find it early. We still don't have the scientific evidence to demonstrate absolutely, without any doubt, that the earliest detection of prostate cancer is necessarily going to increase survival or the quality of life for those men.

COOPER: And so the bottom line is, I mean, talk to your doctors and get as much information as you can?

LICHTENFELD: Ultimately, that's correct. You need to make a decision, an informed decision, based on the information that's available at the time. And the best person to help you with that is your doctor or your health care provider. This is a very complicated and complex situation. It's tough to understand. It's tough for people like me to understand.

So consequently, I would strongly recommend, and the American Cancer Society recommends, that men talk with their health care providers to get the best available information for them.

COOPER: All right, Dr. Ken Lichtenfeld, appreciate you joining us, trying to shed some light on this. It is a tough subject. Appreciate it.

LICHTENFELD: Thank you.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com







Aired July 24, 2003 - 19:36   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
COOPER: All right, well, a common test for prostate cancer, which kills 29,000 men a year, may not be as accurate as previously thought. A new study says the prostate-specific antigen blood test, also called a PSA test, that's how you probably know of it, fails to detect, get this, 82 percent of tumors in men under 60, 82 percent. For older men, 65 percent of cases reportedly go undiagnosed.
Now, some potentially alarming news, certainly. What does this study mean, exactly?

Dr. Len Lichtenfeld is deputy chief medical officer for the American Cancer Society. He joins us tonight from Atlanta.

Doctor, thanks for being with us.

I got to tell you, when I first read the study, I mean, it sounds incredibly alarming, 82 percent of these cases go undiagnosed in people under 60. Is it that bad?

DR. LEN LICHTENFELD, DEPUTY CHIEF MEDICAL OFFICER, AMERICAN CANCER SOCIETY: Anderson, it does sound alarming, and I don't think it's as bad as it sounds. What this study does -- and I might point out that this is a study of numbers, not a study necessarily of large numbers of people. What the study suggests is that if we biopsied more men with lower values, we'd find more prostate cancer.

Actually, that's not new information. We've always known that. And what the study also does is perhaps add more confusion around prostate cancer, both with respect to what we need to do to diagnose it early, and whether or not diagnosing it early really makes a difference in the outcomes, in the survival and the quality of life for those men where we do make that diagnosis.

COOPER: Well, now, I've always understood that if you get this PSA test and it's above 4, then perhaps you should get it biopsied. But basically, what the people who are behind this test say is, actually that number should be lower. If you get a PSA reading, I think, around 2.6 or above, then you should maybe think about biopsies. I mean, what, where, what the advice here?

LICHTENFELD: Well, let's understand, Anderson, that in reality, that four -- that number of four has only been a relative number. We've always known that younger men have very low values, and that if we follow that value, and suddenly it goes up, for example, from zero to 2.5 or to 3, then perhaps we should be concerned and consider biopsy. There were -- the 4.0 number or the 4.1 number is not absolute. It's relative. And let's not also forget that there are a lot of men who have a value over 4 that they don't have prostate cancer. All they have are enlarged prostates.

Even saying that, there are a lot of men with prostate cancer where we now know it will not make any difference in their lives if we find it early. We still don't have the scientific evidence to demonstrate absolutely, without any doubt, that the earliest detection of prostate cancer is necessarily going to increase survival or the quality of life for those men.

COOPER: And so the bottom line is, I mean, talk to your doctors and get as much information as you can?

LICHTENFELD: Ultimately, that's correct. You need to make a decision, an informed decision, based on the information that's available at the time. And the best person to help you with that is your doctor or your health care provider. This is a very complicated and complex situation. It's tough to understand. It's tough for people like me to understand.

So consequently, I would strongly recommend, and the American Cancer Society recommends, that men talk with their health care providers to get the best available information for them.

COOPER: All right, Dr. Ken Lichtenfeld, appreciate you joining us, trying to shed some light on this. It is a tough subject. Appreciate it.

LICHTENFELD: Thank you.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com