PSA Testing Expert Discusses Prostate Cancer Protocol

Following a series of PSA Tests for prostate cancer, a patient sued his general practitioner for failing to notify him of his own health developments. The tests had initially been conducted as a routine checkup, since the patient had been exhibiting signs of low testosterone and erectile dysfunction. Though three PSA Tests were performed, and the patient’s score increased dramatically between each checkup, he was allegedly not warned until his doctor recommended him to a Urologist. The medical records from his consult indicated a rapidly developing cancer case, causing the patient to claim his general practitioner had been negligent in observing standards of care.

Question(s) For Expert Witness

1. How often do you see patients with prostate cancer?

2. What kind of measures should be taken by a family physician if prostate cancer is suspected?

Expert Witness Response E-040945

I am a full-time family medicine faculty physician and I also teach medical students and residents. I have given many lectures on evidence-based medicine including PSA screening-related issues. I have seen a number of patients with prostate cancer and I am very familiar with guidelines for screening and evaluating possible prostate cancer. If cancer is suspected based on exam findings then diagnostic testing or referral are appropriate; if it is suspected based on blood test (PSA) then the same steps would be appropriate. This patient's initial PSA was very close to the margin. This kind of marginal value should probably be followed with more frequent than annual testing.