PSA Test Controversy Discussed by Prostate Cancer Expert

A primary care physician was named in a lawsuit after one of his patients claimed that his PSA prostate testing was conducted negligently. Five years prior, the primary care physician had recommended PSA testing to his patient. The core was well below the accepted cutoff line, and the patient was not tested again until this past year. His PSA results had risen by one point and was half a point away from the guideline limit to order a prostate biopsy, but the patient’s doctor allegedly considered a digital rectal exam to be unnecessary. The patient ultimately consulted a urologist later that same year and was diagnosed with cancer; he promptly claimed that his physician had been negligent in his cancer screening process.

Question(s) For Expert Witness

1. How often do you treat patients like the one described?

2. What PSA result is typically indicative of a digital rectal exam needing to be conducted?

Expert Witness Response E-000369

The PSA test is controversial, particularly in older men. I do not routinely get PSA or do rectal exam in men in this age group, since cancer of the prostate is not usually aggressive.