When you get a PSA test, you should keep track of your level. This would be an excellent time to talk with your physician about the meaning of the test results. For future tests, you should also be aware of any increases in your PSA level and discuss those with a doctor. The earlier prostate cancer is detected, the better your chances of treatment and survival.
VPCa recommends that all Veterans over the age of 40 have annual prostate examinations. Veterans along with African American men and men with a family history of prostate cancer. All of these are considered at-risk for prostate cancer.
Many organizations are recommending African American men or men with a family history of prostate cancer begin screening at age 35. If you have a personal physician, make sure that screening tests are conducted annually. Many community organizations also hold annual prostate cancer screening events, which provide opportunities to be tested free of cost.
Benefits of early detection include the possibility that the PSA test may indicate cancer, which can be confirmed or not confirmed through a biopsy test in consultation with a doctor. If confirmed and found early before it has spread, your doctor will have a better chance to prescribe a treatment leading to cure and long-term survival. In any case, testing can give you peace of mind. VPCa recommends that before having a biopsy to confirm diagnosis of prostate cancer indicated by a PSA/DRE test, a doctor should be consulted for a fully informed decision.
PSA TEST SHOULD YOU BE SCREENED? Prostate cancer is highly curable when detected at an early stage. The PSA screening test, mainly if performed regularly (annually for someone without prostate cancer), dramatically improves the chance of catching the tumor. At the same time, 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 tumor is seen 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 called “cancer” but will probably never be a risk to their lives. Patients 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. Some treatments for prostate cancer can lead to lifelong side effects, 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 able 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 valuable 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 low-grade cancer that could be safely monitored is given overly aggressive and unnecessary treatment.