The Kimmel Cancer Center's Theodore DeWeese testified about prostate cancer screening detection before the U.S. Congressional Committee on Oversight and Government Reform on March 4, 2010. The hearing was called by Maryland Congressman Elijah Cummings. DeWeese was invited to testify by Cummings and Ranking Member Darrell Issa of California. DeWeese, a prostate cancer expert who has treated more than 2,000 men throughout his 15-year career, called for increased federal funding to develop prostate cancer imaging techniques and perform genetic analysis of the disease. DeWeese, who also is Director of Radiation Oncology and Molecular Radiation Sciences, said research in these areas would help fill existing voids in prostate cancer management.
The PSA test currently used to screen for prostate cancer is specific to the prostate but not specific to cancer. In other words, says DeWeese, an abnormal PSA means that there is a change in the prostate but not necessarily a prostate cancer. Currently, the only way to know for sure is to perform a biopsy which involves injecting several needles through the rectum into the prostate. This too, has its limitations as doctors cannot precisely target the needles, leading to incorrect diagnoses in certain patients. DeWeese called for research funding to develop imaging techniques that would allow clinicians to see the prostate during the biopsy and guide placement of the needles directly into areas suspicious for cancer.
While DeWeese says PSA testing and biopsies have been useful in detecting prostate cancer, it also has led to many men being treated unnecessarily and needlessly suffering from side effects of treatment, including incontinence and impotence. He believes that research of the genetic alterations that lead to prostate cancer development could help distinguish cancers from non-cancers, and very aggressive forms of the disease that require a cadre of therapeutic approaches from more indolent forms that may not need treatment at all or certainly can be cured or kept at bay with far less intensive interventions.