Statistics say that one man in every six will get prostate cancer in his lifetime, making it the most common type of cancer found in men in the US, and (after lung cancer) the second leading cause of cancer death but a recent major European trial has produced evidence that one in eight men screened for prostate cancer will test positive when they do not have the disease, often undergoing invasive tests such as biopsy as well as potentially unnecessary treatment, which can leave them with impotence and incontinence.
Screening with prostate specific antigen (PSA) is not routinely offered in the UK but it is being considered and government experts are reviewing evidence from this study and research in the US where the prostate cancer blood test is, currently, the principal diagnosis for prostate cancer. However, this year there has been a change in the guidelines for medical practitioners, with active surveillance being recommended instead of treatment for men with very-low- risk prostate cancer (also known as ‘insignificant’ and classified as life expectancy estimated at less than 20 years), and low-risk prostate cancer ( survival rate of less than 10 years).
The other concern in the US regards treatment since both surgery and radiation have their pros and cons but there is no clear view as to which one is best and a study in 2008 concluded that not enough scientific evidence existed to identify which treatment was most effective at prolonging life or limiting side effects like incontinence and impotence.
The waters were further muddied by an interview with Dr Richard Ablin, the scientist who discovered PSA, in which he announced that it cannot detect cancer effectively and adopting it for the US screening program was, in his view, a huge mistake.
Dr Ablin’s research was aimed at finding a unique protein which could detect unequivocally the presence of this type of cancer. However, his discovery has been a huge disappointment to him because it failed singularly in that regard, since elevated levels can also appear when a man has benign swelling of the prostate (BPH), infection (prostatitis), neither of which naturally predisposes a man to prostate cancer. Strangely, the levels can also rise when he’s been taking ibuprofen, which really does not help.
Another problem is that PSA testing is unable to distinguish between harmless, slow-growing tumors and those that will develop into dangerous cancers, although it has led to suspected tumors being diagnosed much earlier but with a negative effect in that many patients rush into unnecessary therapies that drive up costs and risk complications.
There are also problems with consistently low readings for obese patients. A study of over 13,000 men who had undergone prostate cancer surgery found that patients with a BMI (body mass index) of 35 or more had PSA concentrations that were as much as 20% lower than normal-weight patients with a BMI of less than 25.
Active surveillance is considered a better option because prostate cancer is generally slow-growing and, because most sufferers are over 65, 40% will die from other causes before their cancer requires treatment.
A lot of medical professionals still believe that PSA testing has a role to play in he diagnosis and treatment of the disease if active surveillance (or watchful waiting) is employed. Regular blood tests can track the PSA levels and a sudden rise could indicate that there is cause for concern, especially for those who have a family history or who have already been treated.
probably won't get many more takers here till 2016 (when the new health care is in place.
Of course, I moniter what I feel like, hoping against hope to not cotract that one.
I won't be going to the VA till I know for sure that something is wrong. They aren't near as happy about “testing” or physicals as a prevention thing.
I just cross my fingers (which does nothing) and hope for the best (still, nothing) and maybe I'll luck out that my benign breast thing is all I'll get.
Ain't that something?
I had a lump (1972) and had it taken out, checked, benign.
Ahhhhhh.
I was still a smoker back then.
Scared the heck out'a me.
Tumours are scary even if they are benign. Glad to hear you are ok and that you've quit smoking. Inhaling substances of that nature regularly cannot be good for you. I think it's a good idea for men to monitor their own health. With prostate problems it's watching for problems with peeing, erections and ejaculation. If you start to notice anything untoward, you should see your GP and have a rectal. I know it's unpleasant and embarrassing but he'll be able to tell you if the gland is bigger than it should be and you can start the process of watchful waiting with regular psa tests to see if there are changes in the levels.
Since the advent of this outlook in the last year or so, I've had two PSA tests. Both times, I remember that my urologist said, when I asked him about the research, “You wanna die?” A blatant overreaction, I thought. But since my last visit, I have found someone a bit younger, more informed and willing to talk with me. Part of this, I'm convinced, is 1) the doctor not wanting any of the traditional power taken away…and 2) the damned insurance companies.
It's good to get it all out there, so we can make INFORMED decisions from all perspectives. Thank you, honey, for helping.
Ron, if you google Dr Ablin, you will see a lot of the theories as to why PSA was taken up as the test against the advice of its developer. The research about links between high animal fat consumption and higher risks of prostate cancer is something to be considered.