Article Written By Geoff Ledgerwood, MD, Urologic Surgeon

Recent reports have brought into question the necessity of the prostate-specific antigen (PSA) screening tool for prostate cancer detection; arguing it is almost too effective, leading to over-diagnosis and unneeded procedures. Because there are different types of prostate cancer — up to 24 types with varying degrees of aggressiveness according to University of Michigan researchers — the PSA test is unable to differentiate between the different types, and, therefore, some believe it no longer should be offered for routine screening. However, until an effective alternative is discovered, the PSA test will continue to save lives when offered with patient education and careful consultation and application.

About Prostate-Specific Antigen Screening

The PSA test has been offered as a screening tool for more than a decade. It is a simple blood test that measures the level of prostate-specific antigen—a protein unique to cells of the prostate gland. While PSA levels can rise for reasons other than prostate cancer (such as Benign Prostatic Hyperplasia (BPH) and prostatitis), urologists can use an abnormal PSA result to recommend further testing to diagnose prostate cancer. Benefits of the PSA test include:

• Non-invasive
• Low cost
• Highly effective (when offered with patient education)

Genetic Testing on the Horizon

As scientists discover more genetic information about prostate cancer, they are creating new tools that can help lower the number of unnecessary diagnostic and treatment procedures. A new genetic test, called the PCA3 test, is being investigated for men with abnormal PSA results. The test (sometimes called a “liquid biopsy”) will show if a specific gene—PCA3—is present. PCA3 only shows up in the urine of men who have prostate cancer, and could help patients avoid unnecessary surgical biopsies. Right now, the PCA3 test is only available in Europe and has not yet been approved by the US Food and Drug Administration (FDA).

Prostate Cancer Screening Recommendations

Advanced Urology follows the American Urological Association’s screening guidelines for prostate cancer, which state early detection and risk assessment, including the PSA test and the DRE (Digital Rectal Exam), still should be offered to men 40 years of age or older who wish to be screened. The key to effective use of the PSA tool is patient education and ongoing communication between doctor and patient.

Treatment Options for Prostate Cancer

The good news is that if prostate cancer is discovered through the use of the PSA and other diagnostic tools, treatment for this disease has advanced considerably. With minimally invasive and nerve-sparing options, patients are returning to their lives faster, and with minimal disruption. Advanced Urology offers the following leading-edge treatments if prostate cancer is found and treatment is deemed necessary:

• Minimally invasive, robot-assisted prostatectomy using the da Vinci^® Robot
• Perineal prostatectomy
• Nerve-sparing radical prostatectomy
• Brachytherapy

Get Screened

This year, more than 200,000 new cases of prostate cancer will be diagnosed and more than 30,000 will die from the disease. Because this disease is so treatable when caught at its earliest stages, it remains vitally important that men at risk for prostate cancer discuss screening options (including the PSA test) with their doctor. If you’d like to discuss screening options with an Advanced Urology physician, contact us or complete our online appointment request for an appointment.