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The Patrick C. Walsh Prostate Cancer Research Fund
Helping Men Navigate Treatment and Screening
“My PSA is a little high. Should I get a biopsy?”
“I have prostate cancer but the doctor says it’s slow-growing. Should I go ahead and get it treated?”
“I’m 79 years old. Should I s till get screened for prostate cancer?”
“I’m 41 years old. I got m y PSA tested last year. Should I get screened for prostate cancer this year?”
Although our ability to tr eat prostate cancer has never been better, making decisions about prostate cancer screening and treatment have never been more confusing — “for patients, their doctors, and even for population health managers, whose job is to design and monitor cancer screening and treatment programs,” says Scott Zeger, Ph.D., The Nancy and Jim O’Neal Scholar. The water is muddy, and Zeger, a professor of biostatistics, and urologist H. Ballentine Carter, M.D., are hoping to add a little clarity. With support from the Patrick C. Walsh Prostate Cancer Research fund, they are launching a pilot study, “a collaboration between prostate cancer medicine and statistical science to build a pr obability model,” says Carter.
The model will take into account the screening and treatment decisions faced by Johns Hopkins patients, make estimates from published and patient data, and use these findings to “better understand where clinical interventions can maximize the chance of positiv e prostate health outcomes.” Currently, “it is challenging at both the level of the individual patient and also of populations,” says Carter, “because men who do decide to be screened then face decisions about whether to h ave a biopsy if their PSA is a little high and, if cancer is found, which treatment option to pursue.”
All of these decisions, Zeger adds, “entail weighing potential benefits against potential harms. “A clear understanding of the potential harms and benefits of the options at each decision point will be critical to help men decide what they should do.”