PSA TESTING

PSA testing is a controversial test for determining prostate health. PSA testing works by detecting levels of prostate-specific antigen (PSA) in the patient’s blood. Prostate-specific antigen is a protein produced by the prostate used to liquefy semen (2). These levels are generally low but may be elevated when the patient has prostate inflammation, enlargement, or prostate cancer (1). Doctor recommendations vary, but most agree that patients should at least be aware of the benefits and drawbacks of PSA testing. At Oliver Law Firm we agree.

It is important to remember that elevated PSA isn’t necessarily indicative of cancer, but it can be. The FDA has approved PSA testing along with a digital exam to detect cancer in men 50 and over (1). Medicare currently covers PSA testing. The benefit of PSA testing lies in its ability to detect prostate cancer before symptoms are present, which is especially important in fast-growing cancer which may spread to other areas of the body. Risk factors for prostate cancer such as age, race, and diet should be considered when deciding to have a PSA test.

PSA testing is also helpful in detecting the recurrence of prostate cancer. PSA levels are generally elevated well before other warning signs of cancer recurrence can be detected. This ideally allows for treatment of recurrent cancer before it spreads or grows significantly.

However, in one study 65%-75% of patients with elevated PSA were found NOT to have cancer (3). This means that patients need to weigh the potential benefit of early detection against the risks of unnecessary tests and cancer treatments due to elevated PSA. Risks of these tests and/or treatments include urinary incontinence, erectile dysfunction, bowel dysfunction and infection (1,2). These risks may be unnecessary because the majority of patients with elevated PSA do not have cancer, some prostate cancer is slow growing, and not all prostate cancer requires treatment (2).

Ultimately whether to get a PSA test is up to you and your doctor. The results of a PSA test should be discussed with your doctor to determine what it may signify, and what action to take, if any.

Sources
1. https://www.cancer.gov/cancertopics/factsheet/detection/PSA
2. https://www.mayoclinic.com/health/prostate-cancer/HQ01273
3. Smith DS, Humphrey PA, Catalona WJ. The early detection of prostate carcinoma with prostate specific antigen: The Washington University experience. Cancer 1997; 80(9):1853–1856.