Fun with PSA

Sorry I dropped off for a couple weeks, but it's been a bit of an anxious time.

About 6 weeks ago, my family doctor told me a blood test had shown an elevated "PSA". This was part of a series of standard tests he did, as part of renewing some prescriptions. He explained to me that "PSA" was "prostate-specific antigen" and can be an indicator of prostate cancer. If the number exceeds specified ranges, further investigation by a Urologist is recommended. In my case, being 43, I should have been in the 2.x range (which was where I tested 2 years ago). This year, I was slightly above 4, which put me in the "concerned" range. So, off to the Urologist I go.

I would like to note that I was not having any symptoms of prostate trouble, and was told this would not be unusual for early stage Prostate cancer.

My first appointment with the Urologist involved a follow up exam, verifying that there was not any other obvious issues. The Urologist suggested scheduling a Prostate biopsy, and a second PSA test was ordered, just to make sure there wasn't some odd reason for the original high rating. This second test came back a tad lower, but still within the "concerned" range. So, the biopsy appointment was kept on the calendar.

Last week, I had the biopsy taken. This was not what I would call a pleasant experience, but probably is far less troubling than previous methods. If you want details of this procedures, it is explained at http://men.webmd.com/prostate-biopsy I was told 12 samples were taken. After a few days, I was told that all samples tested negative and I do not have any prostate cancer at this time. There are still some ongoing issues with the recovery from the biopsy, but nothing I haven't been warned about.

So, why tell you this? Well, if caught early enough, Prostate Cancer has a high survival rate (over 90% will survive). The current PSA test isn't full proof, and there are many factors that can contribute to a high result. However, the PSA test has also been catching many Prostate cancers in the early stages, and is felt to be a major contributor to improving the survival rate. As I was told, in the early stages of Prostate cancer, there can be no symptoms. It is reported that by the age of 40, men should be having a PSA included with their regular blood tests. There needs to be a "base" level determined, so any increases can be monitored. In my case, my PSA numbers almost doubled within 2 years, which was concerning.

There is some concern about PSA tests and Prostate cancer being very slow growing, and that many men will die from other ailments before the Prostate cancer becomes an issue. This is reported to be more of an issue in older men (say, over 70), but with younger men (say, under 50) Prostate cancer could spread to other parts of the body and become a serious threat. It all depends on the age of the individual, and what other ailments are in play. On the other side of the coin, it is reported that Prostate Cancer is the 2nd leading cancer killer of men (exceeded only by lung cancer). It is also reported that 1 in 6 men will have Prostate cancer. There are many contributing factors, but bottom line is that many men will get to have some dealing with this.

If you are over 40 and don't know if you've ever had the PSA test done, you should talk to your family doctor about it. Getting the "base" level set can be important for your future health. I know recent reports are saying that men over 75 should seriously consider not bothering with PSA, and I can understand that point. But, I'm talking about much younger men. In my opinion, avoiding the issue could result in much more serious problems.

A related note is that biopsies performed based solely upon elevated PSA levels return a positive cancer result in less than 30% of the cases (typically much less). I wouldn't say this is reason to avoid the procedure, but is more a reason to not get overly anxious about the procedure. As I've been told, the most reliable way to determine whether cancer exists is via the biopsy. However, it's not 100% reliable, as there is always a chance that all samples taken happen to not reveal a growing cancer.

My point: If you're a male over 40, you need to at least ask your doctor about PSA and how it relates to your specific health care.