Yea or Nay for the PSA in the USA – Prostate Testing

It always disturbs me when I see conflicting reports. It confuses me and throws seeds of doubt in the back of my mind about the credibility of all studies. This past week we saw dispersions cast upon the PSA test. This stalwart in the battle against prostate cancer is credited for the saving of countless lives, yet the latest data has revealed the “clay feet” of this standard test.

If you just read the headlines and not the full stories you can get a false or distorted impression. The stories this past week about PSA testing are a good example of headlines that say quite opposite things – things that make you think “What should I believe?” Yet, a calm and logical reading of these articles can help you make informed decisions about the handling of the disease.

Ultimately you are responsible for deciding your own treatment based on your doctor’s recommendations. It is best to have all the facts so that you can weigh the odds.

In the United States, between 28,000 and 30,000 men die of prostate cancer each year. Yet, because of two new studies, it appears that some researchers today are saying that the standard PSA test for prostate cancer is near useless and should not be used.

That’s a pretty radical position to take considering that it is standard practice by most doctors in the US to run the test on all men 50 years old and older. Testing even sooner than that is recommended if there is a history of the disease in the patient’s family tree.

In a nutshell, here is the problem.

It is reported that the PSA shows up to 75% false negatives
It is also reported that the PSA shows up to 20% false positives
The antigen that the PSA test is measuring is not a “true” cancer marker. Benign prostate hyperplasia (BPH), a common non-cancerous condition, can trigger this antigen.
There is currently no “true” prostate cancer marker.

Some studies show that many lives are still being saved by acting on the data from the PSA test. Unfortunately, the treatments can be quite radical and can cause some major lifestyle adjustments and there are associated “quality of life” issues. In the latest European studies, out of every 50 men treated for the disease, one life was saved and the others received the treatments needlessly.

Not only is the PSA test easily fooled by benign inflamed prostate conditions, but some of the cancerous tumors detected by the test are very slow growing and never pose a significant threat to the life of the patient.

There is currently no test to detect whether the cancer, once fully detected, is of the “fast moving” type, which is life threatening, or the “slow moving” type which is not. Adopting a “wait and see” policy will eventually show which it is. The problem with “wait and see” is that if you wait too long the cancer may metastasize – that is, move to other organs.

Each person must decide, for themselves, how to handle this issue. Do you even want to know if your PSA is elevated? If it is elevated, do you want to choose chemo, radiation, radical surgery or should you adopt a more risky “wait and see” position?

Once you are diagnosed, your physician can help you with these decisions. An even better option is to think ahead of time about the course of action you want to take if you get the diagnosis. In that way, you will not be caught “off guard” at a time when clear thinking is required.

You can do more research on prostate cancer on this site by going to the prostate cancer page and reading all the recent articles. You can also search the internet for other resources on this subject.