Screening for Prostate Cancer with The PSA Blood Test
The Prostate Specific Antigen (PSA) blood test is used to diagnose prostate cancer. Prostate cancer is the most commonly diagnosed cancer in men and the second leading cause of cancer death in the United States. Every year, approximately 200,000 men are told for the first time that they harbor this disease. Approximately 30,000 men die of prostate cancer every year.
Should You Be Screened?
Prostate cancer is highly curable when detected at an early stage. The PSA screening test, especially if performed regularly, greatly improves the chance of catching the tumor while it is still confined within the prostate, before it has metastasized. If prostate cancer is detected early, the patient has more treatment options. But if the cancer is detected after it has spread, treatment options become much more limited.
What Are The Benefits of PSA Screening? Risks?
Will an early diagnosis of prostate cancer benefit every single man who undergoes the test? The answer is no. Some forms of prostate cancer are low-grade, posing little to no threat of spreading and becoming life threatening. Low-risk prostate cancer can be safely monitored without any treatment if it remains confined to the prostate. So in theory, there is no need to diagnose these particular individuals because it will only cause unnecessary anxiety and fear about a disease that is called “cancer” but will probably never be a risk to their lives. Patients who are diagnosed with low-risk prostate cancer may have an additional misfortune should they fall into the hands of overly aggressive doctors who administer unnecessarily aggressive treatments, as some treatments for prostate cancer can lead to life-long side effects such as impotence and urinary incontinence.
It is advantageous to know if one harbors early-stage prostate cancer, even if one discovers that it is a form of low-grade prostate cancer that can be safely watched. Armed with this information, one is then in a position to choose between simply monitoring the situation versus adopting a more aggressive approach if higher grade disease is discovered.
Is The PSA Blood Test Perfect?
An abnormally high PSA does not always signify the presence of prostate cancer. Many non-cancerous factors such as prostate infections, enlargement of the prostate gland from aging, and even recent sexual activity can cause PSA elevations. Detection of an elevated PSA can lead to additional tests such as prostate ultrasounds and prostate needle biopsies, which can be uncomfortable and inconvenient, and possibly unnecessary since, on average, three out of four men with elevated PSA levels will not be found to have cancer after the testing is all finished.
If used correctly, the PSA test is a useful test for diagnosing prostate cancer, as it can lead to the detection of prostate cancer in its early stage when it can be cured. The risks associated with PSA testing are unfounded cancer concerns, additional diagnostic testing, and in the worst case, side effects from overly aggressive or unskilled treatment when a man with a low-grade cancer that could be safely monitored is given overly-aggressive and unnecessary treatment.