Cancers diagnosed:
Prostate cancer
Why performed: The benefit of this test is that it can detect signs of early-stage prostate cancer when there are no symptoms. When this cancer is treated in the early stages of the disease, there is a high probability of cure.
Prostate cancer is the second most common form of cancer among men in the United States (the most common is skin cancer) and the second leading cause of death behind lung cancer. The American Cancer Society estimated that nearly 220,800 men in the United States would diagnosed with this disease in 2015, and more than 27,000 men would die from it.
Certain groups of men are at a greater risk of developing prostate cancer. Age is a risk factor; the older a man gets, the higher the risk of getting prostate cancer. More than 60 percent of all diagnosed prostate cancer is found in men sixty-five years of age or older. Men with a family history of prostate cancer in an immediate relative, such as a father, brother, or son, are two to three times more likely to develop the disease. It is also more common among African American men, with more men in this racial group dying from the disease than in any other ethnic group. It is less common in men who are Hispanic, Asian, Native American, or from the Pacific Islands.
In the past, men who at high risk for the disease were advised to begin testing with both a digital rectal examination (DRE) and a PSA test at age forty-five, while all men fifty years and older were advised to be screened. However, there is not currently a consensus among medical professionals regarding the PSA test. For men who have had prostate cancer, the test should be repeated yearly unless a medical provider suggests otherwise.
Patient preparation: No special preparation is needed for this blood test. There are indications that a recent urinary tract infection, a recent urinary catheter, prostate stones, a prostate massage, or a DRE right before the blood test may cause the PSA levels to rise. Therefore, it is recommended to avoid those situations before the blood test in order to avoid a false rise in PSA.
Steps of the procedure: Since this procedure is a blood test, it takes only a few minutes to perform. The blood is then sent to a laboratory for analysis. It may take a few days up to two weeks before the test results are available.
After the procedure: The patient can return to normal activity. It is important to follow up on the results of the blood test to ensure that the PSA levels are within normal limits.
Risks: False positive or false negative results; resulting procedures that may negatively affect other body parts.
Results: There are several ways to interpret PSA results. A more traditional approach considers less than 4 nanograms per milliliter (ng/mL) to be normal, 4 to 10 ng/mL slightly elevated, 10 to 20 ng/mL moderately elevated, and over 20 ng/mL significantly elevated. Other physicians evaluate the PSA level based on age and suggest that the normal ranges vary by age group. For physicians who take that approach, less than 2.5 ng/mL is normal for men forty to forty-nine years old, less than 3.5 ng/ml is normal for men fifty to fifty-nine years old, less than 4.5 ng/mL is normal for men sixty to sixty-nine years of age, and less than 6.5 ng/mL is normal for men seventy or older.
If the initial PSA level is found to be within normal limits, then one of the most important factors in determining whether prostate cancer is present is the change in PSA level from year to year. A dramatic rise in PSA levels from one screening to the next may be indicative of the presence of prostate cancer or other problems with the prostate. When the PSA level is elevated, it is important to have additional testing to determine the cause. Additional tests may include a transrectal ultrasound, in which a small probe is inserted into the rectum to take video images of the prostate, or a biopsy of the prostate, which involves inserting a needle into the prostate to take tissue samples. These samples are then checked for evidence of cancer.
Ablin, Richard J., and Ron Piana. The Great Prostate Hoax: How Big Medicine Hijacked the PSA Test and Caused a Public Health Disaster. New York: Palgrave, 2014. Print.
American Cancer Society. Cancer Facts and Figures. Atlanta: American Cancer Society, 2015. Print.
Bostwick, D. G., et al. “Human Prostate Cancer Risk Factors.” Cancer 101.10 (2004): 2371–2490. Print
Ellsworth, Pamela, John Heaney, and Cliff Gill. One Hundred Questions and Answers about Prostate Cancer. Sudbury: Jones, 2003. Print.
“Prostate Cancer.” American Cancer Society. American Cancer Society, 2014. PDF file.
US Cancer Statistics Working Group. “United States Cancer Statistics: 1999–2011—Incidence and Mortality Web-Based Report.” Centers for Disease Control and Prevention and National Cancer Institute. US Dept. of Health and Human Services, 2014. PDF file.
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