Men Should Not Give Up on PSA Prostate Cancer
Screening, Just Yet
Urologists argue that men should not be swayed from
getting the test - it still saves lives
May 13, 2009 - What’s a guy to do? While prostate
specific antigen (PSA) testing has been the standard screening tool for
prostate cancer for several decades, results of a study recently
published in The New England Journal of Medicine question the
effectiveness of PSA screening in reducing death from prostate cancer.
But many urologists argue that men should not be swayed from getting the
test - it still saves lives.
Matthew Shuford, M.D., urologist on the medical
staff at Baylor University Medical Center at Dallas, sees no reason to
give up the PSA screening in light of the recent findings.
Sarcosine is better indicator of advancing disease
than traditional prostate specific antigen test (PSA); it is detected in
urine, researchers hopeful simple urine test can be used
“Prostate cancer is the most common cancer in men
and the second leading cause of cancer death in men,” says Dr. Shuford.
“Keep in mind that it is only curable when caught early; it can only be
caught early by screening; and the screening is a simple blood test that
is cheap and easy.”
Approximately 90 percent of all prostate cancers
are currently diagnosed at an early stage, according to the National
Cancer Institute.
“Early diagnosis greatly increases a man’s chances
of successful treatment,” adds Dr. Shuford.
Prostate cancer screening includes a digital rectal
exam (DRE) and a simple PSA blood test. The American Cancer Society
recommends men talk with their physician about a regular screening plan.
While some men might complain that the DRE
screening is too uncomfortable and some researchers might suggest that
the PSA test is not necessary, Dr. Shuford is quick to compare the
screening to other cancer screening tests.
“Colon cancer screening, for example, is a more
expensive and a more invasive procedure than prostate cancer screening,
involving the increased complications of anesthesia with the added
discomfort of a bowel prep,” he said. “This is accepted despite the fact
that the vast majority of people will have no abnormality found and even
fewer will have colon cancer.”
“What if a blood test existed for colon cancer,”
asks Dr. Shuford.
“I can’t think of anyone who would say no to a
blood test that may let them avoid a colonoscopy,” he said. “This is
what the PSA test does for prostate cancer.”
About Information Source
Rudy Giuliani, former New York City mayor and
presidential candidate, who was successfully treated for the disease in
2000, will be featured at a program called EveryMan hosted by the
Baylor Health Care System Foundation on May 13, 2009. Giuliani's father
died of prostate cancer in 1981. The fund-raising event for prostate
cancer research will be at the Ritz Carlton in Dallas. For tickets and
information e-mail
BaylorEvents@BaylorHealth.edu with EveryMan in the subject
line or call 214-820-2681.
For more information about Baylor University
Medical Center at Dallas, visit
www.BaylorHealth.com or call 1-800-4BAYLOR.
What is the
prostate-specific antigen (PSA) test?
Prostate-specific
antigen (PSA) is a protein produced by cells of the prostate gland. The
PSA test measures the level of PSA in the blood. The doctor takes a
blood sample, and the amount of PSA is measured in a laboratory. Because
PSA is produced by the body and can be used to detect disease, it is
sometimes called a biological marker or a
tumor marker.
It is normal for men
to have a low level of PSA in their blood; however, prostate cancer or
benign (not cancerous) conditions can increase a man’s PSA level. As
men age, both benign prostate conditions and prostate cancer become more
common. The most frequent benign prostate conditions are
prostatitis (inflammation
of the prostate) and
benign prostatic hyperplasia (BPH)
(enlargement of the prostate). There is no evidence that prostatitis or
BPH causes cancer, but it is possible for a man to have one or both of
these conditions and to develop prostate cancer as well.
A man’s PSA level
alone does not give doctors enough information to distinguish between
benign prostate conditions and cancer. However, the doctor will take the
result of the PSA test into account when deciding whether to check
further for signs of prostate cancer.
Prostate Cancer
The prostate is the gland below a man's
bladder that produces fluid for semen. Prostate cancer is the
third most common cause of death from cancer in men of all ages.
It is rare in men younger than 40.
Levels of a substance called prostate
specific antigen (PSA) is often high in men with prostate
cancer. However, PSA can also be high with other
prostate conditions. Since the PSA test became common, most
prostate cancers are found before they cause symptoms. Symptoms
of prostate cancer may include
>> Problems passing urine, such as pain,
difficulty starting or stopping the stream, or dribbling
>> Low back pain
>> Pain with ejaculation
Prostate cancer treatment often depends
on the stage of the cancer. How fast the cancer grows and how
different it is from surrounding tissue helps determine the
stage. Treatment may include surgery, radiation therapy,
chemotherapy or control of hormones that affect the cancer.
The U.S. Food and
Drug Administration (FDA) has approved the use of the PSA test along
with a digital rectal exam (DRE)
to help detect prostate cancer in men 50 years of age or older. During a
DRE, a doctor inserts a gloved finger into the
rectum and feels the prostate gland through the
rectal wall to check for bumps or
abnormal areas.
Doctors often use
the PSA test and DRE as prostate cancer screening tests; together, these
tests can help doctors detect prostate cancer in men who have no
symptoms of the disease.
The FDA has also
approved the use of the PSA test to monitor patients who have a history
of prostate cancer to see if the cancer has recurred (come back). If a
man’s PSA level begins to rise, it may be the first sign of
recurrence.
Such a “biochemical
relapse” typically precedes clinical signs and symptoms of a relapse
by months or years. However, a single elevated PSA measurement in a
patient with a history of prostate cancer does not always mean the
cancer has come back.
A man who has been
treated for prostate cancer should discuss an elevated PSA level with
his doctor. The doctor may recommend repeating the PSA test or
performing other tests to check for evidence of a recurrence. The doctor
may look for a trend of rising PSA measurements over time rather than a
single elevated PSA level.
It is important to
note that a man who is receiving
hormone therapy for prostate cancer may have a low PSA level during,
or immediately after, treatment. T
he low level may not
be a true measure of the man’s PSA level. Men receiving hormone therapy
should talk with their doctor, who may advise them to wait a few months
after
hormone treatment before having a PSA test.
May 13, 2009 - What’s a guy to do? While prostate
specific antigen (PSA) testing has been the standard screening tool for
prostate cancer for several decades, results of a study recently
published in The New England Journal of Medicine question the
effectiveness of PSA screening in reducing death from prostate cancer.
But many urologists argue that men should not be swayed from getting the
test - it still saves lives. 