Tuesday, September 01, 2015
Hopefully this may clarify confusion over prostate testing
This advice comes from Michael J Misialek, MD, assoc chair, dept of pathology, and assistant clinical prof in pathology at Tufts. He is the guy who looks at PSA screenings and biopsies.
PSA stands for Prostate Specific Antigen. It's a blood test using the same blood they take for cholesterol screening. PSA testing, however, is not always ordered.
--There is no consensus wbout when to start PSA screening or how often to do it. The controversy is that is can lead to costly treatment for cancer that may not be aggressive. Misialek recommends at least talking with your doctor about it at age 40.
--Elevated PSA does not always mean you have cancer. It can be a good indicator, but other things cause elevated PSA, too. Eighty percent of cancers have an elevated PSA.
--A biopsy confirms the diagnosis. This will show the type of cancer if it is cancer.
--Request your pathology report. Talk to the pathologist.
--Be part of your care plan. You will make your own decisions.
--Rushing to surgery and intense treatment is not always best. Sometimes it's best to begin a period of active surveillance to monitor the cancer's growth. If surgery is necessary at some point, it can be followed by radiation, chemo or hormonal therapy.
There are some new tests coming, also. The Prostate Health Index--now in early trials--may be more accurate than the PSA.
Genetic testing may also predict risk. The same gene that is thought to cause some breast and ovarian cancers--BRCA1 and BRCA2--may also be linked to early-onset prostate cancer.
These are areas to explore with your doctor. Don't be afraid to ask questions, do some research, and don't just freak out and insist on surgery to get the thing out...
Think before you react.