PSA testing

I’m going to repeat this from time to time…. I am not an expert. If you have any thoughts that you may have prostate cancer, please consult a physician.

One of the tools that urologists use to diagnose and monitor prostate health is the PSA test.

Prostate-specific antigen (PSA) is a substance made by cells in the prostate gland (both normal cells and cancer cells). PSA is mostly found in semen, but a small amount is also found in the blood. Most men without prostate cancer have PSA levels under 4 nanograms per milliliter (ng/mL) of blood.

PSA test results are not foolproof. Many people with elevated PSA scores do not have cancer, and a low PSA score does not always mean a man doesn’t have cancer. It’s almost as if there is some art with that science. Common practice in the United States has been for men with a PSA score higher than 4 nanograms of antigen per milliliter of blood to get a biopsy to look for cancer. Prostate biopsy can be an unpleasant procedure, involving the insertion of a probe in the rectum and retrieval of several tissue samples from the prostate. Among men in their early 50s or younger, a PSA score of more than 2 tends to raise red flags for urologists.

There are a lot of varying opinions about PSA testing.

Prostate-cancer mortality has been declining slowly since 1996. The decline was anticipated to start at about that time after PSA tests were introduced in the late 1980s.

In recent years, several medical groups have come out against previous recommendations for PSA testing.  Here are a couple of articles about PSA testing:

http://www.cancer.org/cancer/prostate-cancer/early-detection/acs-recommendations.html

http://www.uptodate.com/contents/screening-for-prostate-cancer

Even when prostate cancer is found, a patient and his doctor are confronted with the bedeviling question of whether and how to treat it. Doctors agree that many of the cancers represent no health threat.

However, they also know that prostate cancer kills 29,000 men annually, and there is no way to differentiate between tumors that kill and those that do not. The number of prostate cancers caught before they spread to other areas of the body has increased dramatically in recent years, a trend some attribute to PSA screenings.

My cancer has now metastasized, but I am quite confident that with current treatment regimens, and with research that may lead to future treatments, that I will be “on this side of the grass” for several more years. From personal experience, I am convinced that without PSA testing, and subsequent treatment. I might have either been very sick or have already died.