Guest Commentary The “Buffet Rule” for prostate cancer
By Thomas A. Farrington,
Prostate Health Education Network, Inc
[PHEN] Founder and President
BOSTON -- Billionaire Warren Buffet, who is nearly 82 years old, announced that he was diagnosed with prostate cancer. “I discovered the cancer because my PSA level recently jumped beyond its normal elevation and a biopsy seemed warranted,” Buffet explains. Diagnosed with Stage 1 prostate cancer, he has chosen radiation treatment five days a week for six weeks.
Buffet ignored the recommendations of the U. S. Preventive Services Task Force (USPSTF) in having the PSA test. The USPSTF recommends against men older than 75 having the test, and recently issued a draft recommendation against regular PSA testing for all men unless they experienced some “symptom” of prostate cancer. Buffet did not wait for symptoms, based upon news reports, and had he done so there is a good chance that early detection of his cancer at the Stage 1 level would have been greatly jeopardized.
While we are witnessing a push for the “Buffet Rule” to normalize the income tax rates between the rich and those not rich, I am in favor of the “Buffet Rule” for the early detection of prostate cancer using the PSA test.
The Buffet Rule for Prostate Cancer: “Men at all income levels should have the right to know and to choose how to manage their prostate health.”
Ironically, this is the rule in our country today. However, if the current draft USPSTF recommendation is finalized then that right essentially goes away for some that may not have Buffet’s means. Why? It is almost certain that most insurance carriers will no longer cover the PSA test unless a man is visibly suffering from prostate cancer which is much too late for early detection of the disease. I believe this will have a negative impact on all men but could be devastating for those men at high risk for prostate cancer; Black men, men with a family history and Vietnam veterans exposed to Agent Orange.
When President Barack Obama had his PSA test this past October I stated my fears that the USPSTF is driving government policies that will result in a two tiered system for prostate health management. The “Buffet Rule” for prostate cancer should be protected for all men, especially since the death rate from the disease has declined by 40 percent since the rule has been in effect. Why should our country take a step backwards in fighting the second leading cause of cancer deaths among men?
The recommendation against PSA screening ignores Black men
There is a raging prostate cancer crisis in Black America where men are diagnosed with the disease at a rate 60 percent higher than all other men and die at a rate 140 percent higher. This is the largest racial disparity for any type of major cancer in the United States. Even with these unbelievably gloomy statistics progress has been made over the past 20 years as the overall prostate cancer death rate for Black men and for all men has declined by approximately 40 percent. Medical experts and the data collected over this period attribute this decline to an earlier detection and better treatment of the disease. The only test that is available today for early detection of prostate cancer is the PSA test.
The U. S. Preventive Services Task Force (USPSTF) issued this draft recommendation on October 7, 2011: “The USPSTF recommends against prostate-specific antigen (PSA) - based screening for prostate cancer. This is a grade D recommendation. This recommendation applies to men in the U.S. population who do not have symptoms that are highly suspicious for prostate cancer, regardless of age, race, or family history.”
If this recommendation is allowed to drive public health policy then the methods for detecting prostate cancer will be returned to those used prior to the PSA test. There is a history, and data, to know exactly what the outcomes will be; a majority of men will be diagnosed with metastatic incurable disease resulting in a higher death rate and increased suffering. The harshest impact will be on Black men and other men at high risk for the disease. However, the USPSTF is basing its recommendation primarily on data that does not include a statistically significant number of Black men.
The Prostate Health Education Network, Inc. (PHEN) hosted a live webcast on Wednesday, October 12th (2011) to explore the PSA screening debate and its impact on Black men. We assembled some of the leading medical experts to address this issue. I urge you to learn more about this debate by viewing this webcast which is available in its entirety on this website.
I am an 11-year prostate cancer survivor in good health today with no discernable side effects from my treatments. I have also witnessed the deaths of my father, both grandfathers and only brother-in-law from prostate cancer. I know the benefits of PSA testing and the horrible death that men experience from the disease. We cannot allow a public policy that would return us to the days of increased deaths and suffering – we have a better option.
I am asking that all of PHEN partners, survivor members and those that care about men’s health to join me in taking action against the USPSTF recommendation. For the USPSTF to make a recommendation that ignores the very existence of the men most impacted by prostate cancer is an insult and irresponsible. Let your voices be heard on this issue! Email your U. S. Congressional leaders, and make your comments to the USPSTF.
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