So there is some debate at the moment whether or not PSA tests should be covered as part of OHIP.
Rocco Rossi, former mayoral candidate and CEO of Prostate Cancer Canada, wrote an op-ed piece on the Star for the need for testing. Interestingly there are two comments, by Dr. J. Owen and Dr. P. Fafard which speak out against PSA as a test. The argument that both commentators make is that the PSA test has numerous false positives and that it can lead to unneeded biopsies.
Sometimes the anxiety of the dreaded “C” word also leads to unnecessary treatment. All prostate cancer treatments have side effects so there are men out there suffering with some side effects they probably didn’t need to.
I find it strange however, that as a group the medical profession cannot figure out a simple solution. The PSA test is an indicator, nothing more. So it should be easy to set up a protocol where if the PSA indicates the potential for an issue, you do a follow up PSA test a specific amount of time later. If that also shows an issue then you perform a biopsy. Or you do an MRI with a targeted biopsy.
BREAST CANCER…
- Affects 1 in 9 Canadian women
- 9,300 diagnosed every year in Ontario
- 1,950 annual deaths in Ontario
- OHIP covers cost of screening test
PROSTATE CANCER…
- Affects 1 in 7 Canadian men
- 9,600 diagnosed every year in Ontario
- 1,500 annual deaths in Ontario
- OHIP does not cover cost of screening test
If you look at the stats between breast cancer and prostate cancer the numbers are not that different. I wrote to the various candidates running in the Ontario election and mentioned my own situation. Not surprisingly none of them bothered to reply. The message went something like this:
I am sure you’re office is getting inundated by messages from special interest groups at this important time in the election. And rather than send in a form letter I wanted to make it a little more personal. I am 40 years old and I was recently diagnosed with prostate cancer. This cancer has an excellent survival rate if detected early. However the test to detect it is not covered by OHIP.
For myself prostate cancer was suspected due to a PSA test that was part of a comprehensive physical, and then confirmed with another PSA test I paid for myself. The test costs fifty dollars, so in total a hundred dollars to confirm a potentially life threatening disease.
Recently data on the average life expectancy in Canada was released and pegs the average lifespan for a man to be 80 years. Being 40 I have half my life ahead of me. Isn’t that worth $100? But what if you can’t afford it? Please cover PSA testing with OHIP.
Regards, Dave Hamel
The problem as I see it, isn’t with the PSA test itself, but rather with how patients and doctors react to it and what happens next. If we could look at the issue more holistically then perhaps a protocol could be developed that satisfies everyone. We could detect the cancer early, but avoid unnecessary treatment.