Men's Health

PSA Test May Help Some Men

An expert panel says that men with a life expectancy of more than 10 years should talk with their doctor about getting a PSA test for prostate cancer. This recommendation comes in response to a federal group's recent advice against PSA screening.

Close-up photo of an older man

Earlier this year, the U.S. Preventive Services Task Force argued that PSA tests can't tell prostate cancer from an enlarged prostate, a condition called benign prostate hyperplasia. That uncertainty has led to too many unnecessary biopsies, the task force said.

But the American Society of Clinical Oncology (ASCO) says that uncertainty is exactly why a PSA test - or prostate-specific antigen test - should be part of a diagnosis of prostate cancer.

Other factors

The diagnosis should also include other risk factors like family history, says Robert Nam, M.D., co-chair of the ASCO panel that issued the recommendation.

"Men really need to go to their doctor and have a discussion of the risks and benefits of getting the PSA blood test," Dr. Nam says. "We felt from our review that doing the PSA blood test does save lives in certain groups of men. That's where we differ from the task force recommendation."

The panel's conclusions were based on a study that found that PSA screening could reduce deaths from prostate cancer by 20 percent among a group of men with more than 10 years of life expectancy, even though it did not cut deaths in other men.

Risk vs. benefit

So, why the 10-year cut off? For men with serious or chronic medical problems, treatment and the side effects that come with treatment might be worse than any benefit. They would most likely die from those diseases long before they would succumb to prostate cancer.

Anthony D'Amico, M.D., at Brigham and Women's Hospital in Boston, applauds the new efforts to teach men about the pros and cons of PSA testing. But he stresses that the PSA test is only one factor that can help men understand if they are at risk for prostate cancer.

"The other things that need to be discussed are whether they are at high risk for having high-grade prostate cancer - the kind that kills you," Dr. D'Amico says.

Raising the risk

Factors that increase a man's risk for aggressive prostate cancer include being black or Hispanic, having an abnormal rectal exam, having a family history of prostate cancer, and age. Fifty percent of prostate cancer deaths are in men older than 75.

Dr. D'Amico says men should discuss their risks for prostate cancer with their doctor. If they are at high risk, then a PSA test should be considered. If they are at low risk, a PSA test might not be appropriate.

Always talk with your health care provider to find out more information.

Online Resources

(Our Organization is not responsible for the content of Internet sites.)

American Cancer Society - Can prostate cancer be found early?

National Cancer Institute - Prostate-Specific Antigen Test - Understanding Your PSA Test Results

September 2012

When to Get Checked for Prostate Cancer

Prostate cancer is one of the most common cancers in men. Some men have no symptoms. Most experts agree that you should get tested if you have any of these symptoms:

  • You urinate often, especially at night.

  • You have trouble urinating or trouble starting or holding back urination.

  • You have a weak or interrupted urine flow.

  • You are older than 50 and often have pain or stiffness in your lower back, hips, or thighs.

Many of these symptoms can also be caused by an enlarged prostate, which has nothing to do with cancer. An enlarged prostate is common in nearly all men as they age, and it can be treated. Talk with your doctor if you think you may have this problem.

If your doctor tells you that you have cancer, explore your options. Prostate cancer can grow quickly or slowly. In some cases it can take 10 to 15 years before it poses a threat to a man's health. How well you will do depends on whether the cancer has spread and how aggressive it is. Ask questions. Before you make any treatment decisions, understand the advantages and the risks.

Always talk with your health care provider to find out more information.

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