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Prostate Cancer and the PSA Debate

Screening for prostate cancer is something that men are recommended to do on a regular basis. And for good reason, prostate cancer is one of the most commonly diagnosed cancers in men but it is also easily treated. Because there are often no symptoms associated with prostate cancer – especially in the earliest stages – screening becomes even more important in terms of identifying disease so that treatment can begin immediately.

Prostate cancer screening generally includes a digital rectal exam in a doctor’s office during which the doctor is able to feel for any lumps or unusual growths and the prostate specific antigen (PSA) test during which a blood test measures the levels of PSA in a man’s blood. An elevated level of PSA can indicate the presence of prostate cancer. If either of these screenings indicate the need for further testing, then a doctor may order a trans rectal ultrasound or biopsy to ultimately make a diagnosis.

There continues to be a debate, however, about whether men should include a PSA test in their routine prostate cancer screening.

The reason for the debate is because the PSA test may not accurately translate to the existence of prostate cancer. Elevated PSA levels can also signify the presence of infection or the commonly occurring – and benign – prostate enlargement. In fact, it has been shown that approximately only one in four men who have elevated PSA levels actually have prostate cancer.

The other school of thought is that an elevated PSA level may lead to the discovery of prostate tumors that ultimately are slow growing and would have never grown past the prostate itself or caused any complications whatsoever. Instead, treatment itself for the tumor can cause a variety of complications including incontinence, impotence, infection, and more.

Ultimately, it is recommended that screening for prostate cancer in whatever way makes sense, should be a decision to left to the patient and his doctor.