Prostate cancer is the most common
cancer found in men, and the second leading cause of men's cancer deaths. Given those rates, it
would seem like a screening test that can catch the disease early would be a
major boon to medical care. However, it hasn't been that simple.
The PSA test is a blood test that looks
for a specific protein that is only produced by the prostate. The higher the
levels of PSA, the more likely the person has prostate cancer. If someone is found to have an elevated level,
they are often recommended to have a biopsy taken from their prostate. This
involves inserting 12 needles into the prostate using an ultrasound and taking
a random sampling of tissue. It seemed
as though it would be the answer to help us identify earlier cancers .Before
the PSA test, being diagnosed with prostate cancer was almost a death sentence.
Now, 16 percent of men are diagnosed, but only 3 percent succumb to the
disease.
The problem is that
the majority of tumors are not significant enough to warrant treatment. One
study suggested that 40 percent of men who receive a positive test result have
a cancer too slow-growing to be deadly. The biopsies, radiation, surgery and
other treatments can cause serious side effects, including impotence,
incontinence and other complications -- even death.
Unlike pancreatic cancer or lung
cancer, as the statistics show, many of these [prostate] cancers are not
significant. They would be best not diagnosed. Previously, men over the age of
75 were advised not to get the test.
However, some experts believe that the PSA test should still play a role. Without using the blood test, the only
method left to check for prostate cancers is a digital rectal exam, when a
doctor checks the prostate through the rectum using his or her fingers. Some
tumors can be felt, but not others, and they are often discovered too late. doctors need to is “screen smarter.” He
suggested still using the PSA test and then repeating it to reconfirm if a high
PSA score is detected. Doctors could use an advanced MRI scan to try and locate
the tumor, rather than going in blindly for a biopsy.
In some cases, a man might not need a
biopsy unless their PSA scores keep increasing or they have significant family history.
In other instances, the MRI could help guide doctors to get more accurate
biopsies.
The goal, he explained, is to “identify
those cancers that need to be diagnosed and need to be treated as opposed to
all of those insignificant cancers that the current way we are doing things is
leading to.

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