What Happens When Doctors Do Not Follow Up On Abnormal Digital Exam And PSA Testing

Imagine you are a male and you see your physician for your yearly checkup. Imagine the doctor orders blood tests, including a PSA test for the early diagnosis of prostate cancer. So far, so good. This is how to determine whether a man without any symptoms of prostate cancer might in fact have it. Imagine the results actually were not normal.

Certain doctors argue that prostate cancer screening, specifically PSA testing, is of little or no value. They argue that screening has little, if any, value. If the result of a screening test is abnormal the individual ought to be told about the results and either be referred to a specialist or be advised about the option for diagnostic testing, like a biopsy. Again, however, some physicians also take the position that, at least under certain situations, a male patient who is diagnosed with prostate cancer does not need to undergo treatment immediately and merely needs to carefully monitor the cancer.

Should this happen, the cancer becomes incurable before the patient turns symptomatic and is finally diagnosed. Unfortunately, if a doctor detected that the patient’s prostate was enlarged or there was a nodule on the gland and the PSA test results suggested high levels of the antigen and the doctor did not tell the patient about the abnormal results, the man would likely believe that meant there was no need to follow up.
The longer the delay in actually doing tests that will lead to a diagnosis of the cancer the larger the likelihood that by the time it is eventually diagnosed the cancer will have reached an advanced stage. This will considerably reduce treatment options, will eliminate the chance of a cure, and will shorten the patient’s life. There is a group of cases where the male patient was eventually diagnosed but by that point the cancer was advanced and a cure was no longer a possibility.

Screening tests might have false positives. This means that certain patients with abnormal screening results actually do not have cancer. Yet performing screening tests for cancer is meaningless if there is no follow up as it provides the patient a false sense of security thinking he has no cancer as the physician tested him but said nothing to him that the tests demonstrated he might have cancer. Physicians typically acknowledge that there is a requirement for follow up if the results of screening tests come back as abnormal.