Posted by Brigham and Women's Hospital September 19, 2012
Prostate cancer is the second most common and deadly cancer among
American men. About 1 in 6 men will be diagnosed with prostate cancer during their lifetime, and about 1 in 33 men will die from the disease.
The prostate-specific antigen (PSA) screening test is an important tool for helping to diagnose, monitor, and guide the treatment of this disease. Since the introduction of PSA screening more than 20 years ago, along with the advent of more aggressive treatment, there has been a dramatic increase in the survival rate of U.S. men diagnosed with prostate cancer. This includes, according to a recent study, a significant move toward resolving the disparity between prostate cancer survival rates in African-American men and Caucasian men.
Opinions on when a PSA screening should be performed, or whether it should be performed at all, vary widely among health care professionals. Brigham and Women’s Hospital continues to advocate the selective use of PSA. We believe that, overall, the benefits of PSA screening greatly outweigh the risks, particularly for young and/or healthy men at high risk and when prostate cancer specialists – oncologists and urologists – are interpreting the results to effectively limit unnecessary treatment.
Below is some important information for men who are considering PSA screening.
- What is the PSA test?
The PSA test measures the blood level of a certain protein that is produced by the prostate gland. The higher the level, the more likely it is that a man has prostate cancer.
The test involves a needle stick and drawing a small amount of blood. As with any blood draw, there is a small risk of infection and some bruising.
- Who should get the PSA test?
Not everyone should get a PSA blood test.
PSA tests are typically done annually, starting at the age of 50 for most men and at the age of 45 for those in high-risk groups, such as African-American men and men with a family history of prostate cancer.
Screening and treatment, however, appear to benefit younger and healthier men more than older patients. One advantage to diagnosing a man with prostate cancer at a younger age is that he’s less likely than an older man to die of another disease, and, thus, proceeding with prostate cancer treatment holds greater promise. Another distinct advantage is that it is much easier to detect prostate cancer in a younger man by using the PSA test, as his PSA level is less likely to be falsely elevated by the benign prostate enlargement that often occurs in older men.
- Does an elevated PSA reading mean that I have prostate cancer?
An elevated PSA reading does not necessarily mean that you have prostate cancer. It could be a sign of an enlarged prostate or some other benign condition.
Likewise, a low PSA reading does not necessarily mean that you don’t have prostate cancer. Any PSA results should be discussed with a health care professional to understand their significance.
- What else is used to help diagnose prostate cancer?
The PSA test is only one small part of diagnosing prostate cancer. A PSA screening, a discussion with a health care professional, and a digital rectal exam are all critical to accurately assessing a man’s risk of the disease.
- If I’m diagnosed with prostate cancer, should I get treated?
Not everyone diagnosed with prostate cancer should be treated.
Studies have shown that, overall, less men have been dying of prostate cancer since the advent of PSA screening and aggressive treatment. This is particularly true for younger men.
Many men, however, should be monitored instead of treated. In some cases, prostate cancer spreads so slowly that it’s unlikely to cause death in an older man.
Quality of life is also a consideration. Although treatment may extend a man’s life, it can also have adverse side-effects. Men should talk to a health care professional about the potential benefits and potential negatives.
*As part of Prostate Cancer Awareness month, Brigham and Women’s/Mass General Health Care Center is partnering with their Foxborough neighbors, the New England Patriots and Patriot Place, to offer free prostate cancer screenings on Thursday, September 27, 12 – 6pm and Friday, September 28, 12 – 6pm. Call 1-800-BWH-9999 or register online for your free PSA screening.
If you’d like to hear our specialists discuss the prevention, screening, detection, staging, treatment, and follow-up, of this disease, please attend our 14th Annual Symposium on Prostate Cancer on Thursday, September 20. Call 1-800-BWH-9999 or register online for this free event.
– Chris P