Screening healthy men for signs of prostate cancer using the PSA blood test is controversial – it’s still unclear whether the potential benefits of identifying cancer early outweigh the risks of treating many cases of the disease that would never threaten a man’s health.
Add one more thing to that “risks” column: according to Bloomberg News, the needle biopsies that follow an abnormally high PSA reading are increasingly resulting in infection by antibiotic-resistant strains of bacteria such as E. coli.
Research shows that the risk of post-biopsy infection — while still small — has more than doubled in less than a decade, BN reports. One Australian physician, Anthony Costello, says that two of every 100 men biopsied will develop sepsis, a potentially lethal blood infection. Another study shows that nine of 10,000 men who tested negative for cancer died within a month of their biopsies.
The findings provide more evidence that the PSA and follow-up tests are not necessarily benign. (The American Cancer Society advises men to carefully weigh the “uncertainties, risks and potential benefits” of screening starting at age 50, while the U.S. Preventive Services Task Force says there’s not enough evidence to assess the value of screening in men younger than 75.) One physician tells BN that the infection risk had made him reluctant to order a prostate biopsy unless it’s pretty likely that there’s a cancer that needs treating.
The increased prevalence of infection is also a further sign of the general threat posed by antibiotic-resistant bugs, particularly a class known as gram-negative bacteria. People can pick up these strains and then carry them around for years without any ill effects before they flare up in a vulnerable area — such as the wound created when a needle pierces the bowel wall en route to the prostate gland.
Costello tells BN that men who have traveled to India, China and elsewhere in Asia should postpone any biopsies until six months after they have returned. Some gram-negative bacteria in South Asia have learned a novel trick for deactivating antibiotics, causing a concern about a new wave of so-called superbugs.