Sample Patient Advice and Consent Form for Prostate Cancer Testing
Last Revised August 17, 1995
The following patient advisory materials are being used by Dr Gerald Chodak and his
colleagues at The Prostate and Urology Center, Louis A. Weiss Memorial Hospital in
Chicago. These are a very interesting set of materials. It might be useful
if more physician groups took advantage of these. They are posted here with the permission
of Dr Chodak's office.
A patient's guide to screening for prostate cancer
Currently, doctors disagree over whether men without symptoms should be tested (or
screened) for prostate cancer. Screening has both advantages and potential disadvantages.
Until studies are completed, patients should be able to decide if they want to be tested and the
following information is intended to help make this choice. If you have questions after
reading this information, please ask one of the staff for help.
The case FOR screening:
The case AGAINST screening:
- Advanced prostate cancer is not curable.
- In the absence of screening, only a low percentage of men are diagnosed with early
stage, potentially curable disease.
- PSA testing improves early detection.
- Although screening only once in a man's lifetime may offer little benefit, sequential
testing is likely to offer better results.
- Studies underway to assess the value of screening will not be completed for 10-15
- Screening is the best way to minimize a man's risk from prostate cancer.
In the face of these conflicting ideas, the following is the information currently offered to
men about screening:
- No study has shown that screening reduces mortality from prostate cancer.
- Many men with prostate cancer will die from other causes before
suffering from advanced prostate cancer, therefore neither screening nor treatment is
necessary or beneficial for them.
- Current treatments may cause significant morbidity in some men.
- Improving early detection is not a guarantee that cancer deaths
will be prevented; a similar situation exists fro mammography testing in women ages 40-49.
- Not screening is the best way to maximize a man's quality of life.
Based on this information, I have decided to: (CHECK ONE)
- At present, doctors are divided over the advisability of screening. As a result, each
patient should be informed of the potential risks and benefits and then participate in deciding
whether to be tested.
- The decision about screening depends on each man's goals, fears and willingness to
accept risk. Screening should be performed if an individual wants to minimize his risk from
prostate cancer and maximize his chance of living as long as possible. Screening should not
be performed if an individual wants to maximize his quality of life, minimize his risk for
complications, and only undergo medical tests that are clearly proven to be beneficial.
- The actual screening causes little discomfort since it only involves a blood test and a
digital rectal examination. However, a patient could be harmed by screening if a biopsy is
performed or cancer is detected and treated which results in a complication.
- As men get older, the chance of benefitting from screening decreases.
- Screening is most likely to benefit men with at least a 10-15
year life expectancy, which means that it is most appropriate for men aged 50-65 and least
appropriate for men over 70-75.
- Screening may also benefit men at increased risk including African-Americans or men
with at least one first-degree relative who had prostate cancer.
- If screening is done, both a rectal examination and a PSA should be performed.
- If the rectal exam is normal but the PSA is abnormal, further testing is still needed to
rule out cancer.
- If a PSA or rectal exam is performed and either is abnormal, patients should be offered
a biopsy as an option.
( ) HAVE THE PSA
( ) NOT HAVE THE PSA