P.S.A. on P.S.A

Prostate-specific antigen (PSA) is a protein produced by the prostate gland.  The PSA Test measures the level of PSA in the blood.  During routine testing it is common for men to have low levels of PSA in their blood.  High levels of PSA can indicate pathology of the prostate gland such as prostatitis, benign prostatic hyperplasia (BPH), or prostate cancer.

The PSA Test has come under fire after the U.S. Preventive Services Task Force (USPSTF) released its evidence update on prostate cancer screening.  The update concluded that healthy men (with no prior medical or family history of prostate cancer) should not undergo PSA screening because there was no significant effect on prostate cancer specific mortality – “Screening based on PSA identifies additional cases of prostate cancer, but most trials found no statistically significant effect on prostate cancer–specific mortality.”  The USPSTF also stated “Screening also is likely to result in overdiagnosis because of the detection of low-risk cancers that would not have caused morbidity or death during a man’s lifetime, and overtreatment of such cancers, which exposes men to unnecessary harms.”

You can watch a video of Dr. Oz’s view on the controversy here.  The New England Journal of Medicine (NEJM) came forth with some interesting statistics and published the prostate cancer screening guidelines of the American Urological Association, American Cancer Society, and the USPSTF.  The NEJM also published an article by Richard M. Hoffman, M.D., M.P.H., which has some very interesting points and even more interesting comments.

The take home message here is that the PSA Test, while sensitive to PSA levels, is not specific to malignant prostate cancer in healthy men – men with no family or prior medical history of prostate cancer. The idea is to make a sound, informed decision about your health and well being and not rush foolhardily into unnecessary/potentially harmful treatment.  As always, it is important to discuss your PSA Test results and treatment options with your medical doctor.

Jason Sargis, DAOM, LAc

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