Prostate cancer screening debate rages on
A new study indicates that regular blood testing to measure levels of prostate specific antigen (PSA) is more effective at detecting prostate cancer in men with a genetic predisposition to the disease.
The research, led by Philipp Dahm of the University of Florida, adds to the growing data that while the PSA blood test detects cancer in its early stages, it does not lead to lowered mortality rates. The American Cancer Society this year changed its guidelines to reflect the growing uncertainty over testing.
The primary concern with the PSA antigen test, which is now in its 20th year, is that it can not differentiate between low-risk tumours and aggressive lesions that are often fatal.
Dahm and his team note that a single test at 60 may find the men most at risk, who could then have follow-up screenings every year to check for the first signs of cancer.
Prostate cancer can be easily treated, if it is found in its early stages. It is the most common malignancy other than skin cancer to occur in U.S. men and is the second biggest cause of death from cancer among men. Most cases occur among men aged in their sixties.
The prostate is an exocrine gland of the male reproductive system, and exists directly under the bladder, in front of the rectum. An exocrine gland is one whose secretions end up outside the body e.g. prostate gland and sweat glands. It is approximately the size of a walnut.
The debate over the benefit of PSA testing continues, with many recent large-scale studies. Research has cast doubt on the value on routine PSA screening for most men and raised questions about whether such testing resulted in unnecessary, potentially harmful treatment.
I am baffled by recommendations not to have PSA tested. Mine was at 13.0 several years ago, and as a result I had further tests and then removal of the prostate. The cancer, Gleason 7 (moderately aggressive) had reached the margins. Without the PSA screening I would never have been aware of the cancer (I was asymptomatic except for more frequent urination) until it had spread beyond the prostate. As a result, I am alive and cancer-free eight years later. I hate to think that these pronouncements that testing is useless will doom many men to die, but that seems to be the case. Anyone want to state the opposite side of the case?
This isn’t the opposite side but it means statistically you are an exception to the data. I have prostate cancer on both sides of my family. And it concerns me that the numbers indicate that testing overall is just a crap shoot.
Not to mention how many needless and risky biopsies are done along with a given number of false positives. Maybe this new info will spur research into a better more effective screening test.
Maybe more guys will get yearly physicals now since “the glove” won’t be part of it.