Why should I have a PSA test?
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Dr. Michael Roizen answered:If you're a guy pondering a prostate-specific antigen (PSA) test, the recent flap about prostate cancer screening might leave you with mental whiplash. "Skip it—PSA tests do more harm than good," an advisory panel from the U.S. Preventive Services Task Force (USPSTF) recently concluded. "Get one—it could save your life," counter many doctors and the American Urological Association (AUA).
Who's right? Both sides have valid points: PSA tests are far from perfect. This blood test measures an enzyme produced by your prostate gland. Rising levels might mean prostate cancer, an infection, or no cancer at all. Unfortunately, plenty of guys with positive PSA tests get biopsies and treatments, such as surgery, chemo and radiation, they may not need.
According to the AUA, "until there is a better, widespread test for this potentially devastating disease, the USPSTF—by disparaging the test—is doing a great disservice to the men worldwide who may benefit from the PSA test."
However, if you and your doctor work together, the PSA test can be a big benefit to you. Right now, it's the best early-warning system we have for prostate cancer, which kills 28,000 men in North America every year.
When you're 50 years old, talk to your doctor about getting the PSA test. If you are African-American or have a close male relative who has had prostate cancer (especially if he was younger than 50), start testing at age 45 because you're at a 60% higher risk. If your insurance company no longer pays for it, bite the bullet and get a baseline reading. It may be important for future comparisons.
Waiting for prostate cancer symptoms to develop before getting a PSA test is not a good idea. By then you might have a later-stage, hard-to-treat cancer. Before PSA tests came out, 80% of prostate cancer was discovered only after it had spread and become a lethal situation. Today, PSA tests and subsequent treatments (including important lifestyle upgrades) save 9,000 lives a year..
No matter what, get an annual digital rectal exam (DRE). This rubber-glove exam of your prostate gland can catch the 25% of problems that a PSA test alone misses. You need an annual DRE—along with your yearly physical—even if you and your doctor agree you don't need a PSA test for now.If you're a guy pondering a prostate-specific antigen (PSA) test, the recent flap about prostate cancer screening might leave you with mental whiplash. "Skip it—PSA tests do more harm than good," an advisory panel from the U.S.... More -
Dr. Edward Schaeffer of Johns Hopkins Medicine answered:There are no symptoms of prostate cancer when it is confined to the prostate and curable. At later stages of the disease, it becomes symptomatic and, unfortunately much more difficult to treat. When it has spread from the prostate to other organs and is difficult to treat.
PSA testing can catch disease early, and most men today who are diagnosed have a choice: They can choose immediate treatment or observation.
For those men over 65 years of age with small, non-aggressive tumors, Johns Hopkins has a large “active surveillance” program, in which men are followed carefully for signs that the disease is becoming more aggressive so that they can be treated. Early diagnosis is the cornerstone that has dramatically reduced death and suffering.
In 1991, before PSA testing was in place, 20 percent of men with a new diagnosis of prostate cancer had tumor that had already spread to their bones.
Today, that number is fewer than 4 percent. It’s hard to imagine now, but in 1991, one out of five men had metastases (distant spread of the disease within the body). Today, that number is down to one in 25.
There are no symptoms of prostate cancer when it is confined to the prostate and curable. At later stages of the disease, it becomes symptomatic and, unfortunately much more difficult to treat. When it has spread from the prostate to other organs... More -
Dr. Simon Hall of The Mount Sinai Medical Center answered:Prostate Specific Antigen tests are controversial. Should a man get a PSA test? In this video, Simon Hall, MD, chairman of the department of urology at The Mount Sinai Medical Center, shares his views on the PSA.
Prostate Specific Antigen tests are controversial. Should a man get a PSA test? In this video, Simon Hall, MD, chairman of the department of urology at The Mount Sinai Medical Center, shares his views on the PSA. More
