When the American Urology Association said men 70 years and older should be deleted from the prostate cancer screening process, Dr. Navin Shah immediately felt the need to fight back.
“They (AUA) thought prostate cancer is slow going and men 70 years and older will die anyway before the cancer takes over,” the Indian American physician told India-West. “This is totally wrong.”
From the time the AUA took older men off the prostate cancer screening process, Shah has spent countless hours in an attempt to convince the association their determination was inaccurate.
A practicing urologist in Washington, D.C., Shah wrote a paper published by The Journal of Urology in April 2014 that explained men 70 years and older have more prevalence of prostate cancer, which leads to more cases of prostate cancer having spread, which in turn leads to more deaths from the cancer.
What Shah wants is more regulatory screening for prostate cancer.
“You cannot deny a patient for treatment and screening just because they are 70 years old,” he said.
Shah has since reached out to the Senate and House of Representatives and has received backing to put a bill into legislation, the National Prostate Cancer Plan Act.
Congressmen G. K. Butterfield, D-N.C.; Michael McCaul, R-Texas; Elijah Cummings, D-Md.; and Walter Jones, R-N.C., introduced the bill last month which, if enacted, will allow for better implementation of prostate cancer screening. Senators Barbara Boxer, D-Calif., and Jeff Sessions, R-Al., have sponsored a companion bill in the U.S. Senate.
“There was no prostate cancer screening 20 years ago, and, for every third patient screened, prostate cancer had already spread and death was certain,” Shah explained. “Today, because of screening, deaths from prostate cancer have been reduced by 40 percent.”
Shah contends that if screening is stopped, the deaths will start rising again.
From his studies Shah says the people affected the most by prostate cancer are minorities, especially African Americans, and poor and uneducated people.
Since his article came out disputing the AUA decision, the Indian American doctor said he has received letters of support from the American Medical Association, the American College of Radiation Oncology and even the AUA itself.
Shah told India-West that at this juncture, it’s a waiting game. With the Congress recess in August looming, the bill will not likely be looked at until the powers-that-be return to their offices in early September.
Meanwhile, Shah said he plans to mark up the bill with the Senate, S222, and then the House, HR2730, and have it ready when the Congress recess is over.
He understands that patience is needed when trying to pass a bill through legislation but is still looking ahead to how much this will help.
“This is going to help many men in America and men all over the world,” he said.
Currently, insurance doesn’t pay for prostate cancer screening. If the act is passed, which Shah is very optimistic will happen, screening will be part of the regular annual checkup for men.
That regular screening will allow doctors like Shah to check for early signs of prostate cancer.
“If it’s localized, it can be treated; if it has already spread, it cannot be treated,” he emphasized.
Prostate cancer is the most common cancer in men and is the second leading cause of cancer-related deaths in men. One in seven men will be diagnosed with prostate cancer during his lifetime with nearly 221,000 new cases diagnosed each year, according to a statement released by Butterfield.
Current screening techniques can be improved in order to avoid inaccurate results that either leave many men believing they are cancer-free or lead to painful, costly and unnecessary procedures, Butterfield’s statement added.
Shah, who received his master’s in surgery in Pune, India, and his urology training at the Washington Hospice Center in Washington, D.C., said upward of 50 percent of biopsies are inaccurate in determining the severity of prostate cancer, if there are signs of it.
He cited about half of 13,000 cases that biopsies determined a low-grade cancer ended up actually being high grade.
“I can stand up to the guidelines of the AUA, go to Congress and rectify it,” Shah said. “The avenues are there to correct the wrongs; this is the greatest part of this country.”
Shah has received support from high-profile urology doctors at Johns Hopkins, Harvard, Duke and Northwestern universities.
“We exist to care for our patients,” Shah said of doctors. “And this is one way we can do it.”
Regulatory screening, however, would not be the standardized method until after a report is filed about a year after the bill is signed.