Preventative medicine

PSA tests best means of early detection

BY GRANT WING
THE GLOBE AND MAIL
WEDNESDAY, SEPTEMBER 21, 2005

Leading prostate cancer specialists and survivors are urging men to take yearly PSA tests to monitor their prostate health and benefit from crucial early detection – the best means of preventing prostate cancer.

The PSA (Prostate-Specific Antigen) test, a highly sensitive blood test that detects a distinct chemical produced by prostate tumour cells, remains the gold standard for the early detection of prostate cancer, usually long before it is palpable with a digital rectal examination (DRE).

“PSA is overall the best biologic marker that we have in the world today against a common malignancy like prostate cancer,” said prostate cancer specialist Dr. Steven Strum.

“The PSA is wonderful for a number of reasons,” said Dr. Strum, explaining that PSA levels correlate closely with prostate volume and tumour growth.

“We can look at PSA and track it serially as we would a stock on the stock market. If we can see (PSA levels) growing exponentially, we have a reason to be concerned.” He said men should get a baseline PSA level test at age 40 and check it every year, tracking the numbers sequentially over time. Dr. Strum recommends men have PSA tests done by the same lab each time to ensure consistent results and avoid possible variations in testing. Dr. Strum said awareness of PSA levels allows men to know their prostate health status – essential in determining a logical strategy and best therapy in the event of cancer. Depending on the nature of the PSA increase, the patient’s age and general health, for example, a strategy might include diet and lifestyle changes to help abate a patient’s development of prostate cancer. “We shouldn’t think that a diagnosis of prostate cancer has to equate with some kind of invasive procedure,” he said. James Demers attests to the value of PSA testing. The Ottawa businessman was active in prostate cancer fundraising in his community for years before a series of rapidly rising PSA tests resulted in his diagnosis.

“For five years I listened to doctors and radiologists speak about how important it is to get that PSA,” he said. “That’s when I went to my doctor and though he said everything was okay with the DRE, I said, ‘No, no, we’re going the PSA route and I don’t care how much it costs.’ I’m certainly glad I did.” In Mr. Demer’s case, PSA tests detected prostate cancer that a DRE, ultrasound test and a false negative biopsy had not found. A second positive biopsy led to his recent laparoscopic prostatectomy.

Now on the mend and eager to share his experience, Mr. Demers is doing anything he can to get men to wise up and get the test.

“That’s what I’m telling my friends now,” he said. “Get your PSA tested.”