Did PSA testing save Ben Stiller?

By Corin Kelly
Wednesday, 19 October, 2016


Maybe, seems to be the consensus from the medical community.
The Zoolander star said he was diagnosed with “mid-range aggressive cancer” on June 13, 2014. He underwent surgery and was declared cancer-free three months later.
“It came out of the blue for me. I had no idea,” Stiller, 50, said. “At first, I didn’t know what was going to happen. I was scared. It just stopped everything in your life because you can’t plan for a movie because you don’t know what’s going to happen.”
Stiller said he has finally opened up about his secret cancer battle to encourage other men to get tested early. He underwent a Prostate Specific Antigen (PSA) test when he was 46 — a preventive health exam he says saved his life.
Stiller's declaration has been met with mixed reactions. So why the controversy?

'While a PSA test is not dangerous in itself in any way, it is definitely not foolproof,' writes Ben Stiller in his blog published on Cancer Moonshot. 'The criticism of the test is that depending on how they interpret the data, doctors can send patients for further tests like the MRI and the more invasive biopsy, when not needed.'


'Physicians can find low-risk cancers that are not life threatening, especially to older patients. In some cases, men with this type of cancer get “over-treatment” like radiation or surgery, resulting in side effects such as impotence or incontinence. Obviously this is not good; however it’s all in the purview of the doctor treating the patient', writes Stiller.


Oncologist Vinay Prasad told the Health News Review that there were many flaws in Stiller’s logic. “His strong faith that the PSA test “saved his life” is incompatible with a true understanding of overdiagnosis; no person whose cancer was found by PSA screening can say “the test saved my life”” say Prasad.


Health News Review contributor, Dr Douglas Campos-Outcalt, says Stiller has “over a 95 per cent chance of being wrong” in his analysis of the PSA test. “Screening does more harm than good in these men, (there are people) who are killed by the treatment and a large number who are left impotent and incontinent”.


This wrap up comes from Saurabh Jha, MD,  from an article published in The Healthcare Blog. 'Some say (Stiller's) spreading misinformation by advocating PSA screening. I'd argue that it's not possible to spread misinformation about screening because we don't have a clue. Screening is an information problem; some benefit, some are harmed, but we don't know who will benefit or who will be harmed. This has a name. It's called "uncertainty." Ben Stiller has increased the public uncertainty about PSA screening. I think that's a good thing.'

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