The testing of a man’s PSA level is the most common method of evaluating ones chances of having prostate cancer. I remember when the only way to routinely check for cancer of the prostate was the infamous digital rectal probe. I always dreaded my annual physical knowing that sooner or later I had to drop my pants bend over and assume the position. The purpose of the exam is to feel the prostate in order to detect any lumps or bumps which might indicate a possible tumor. Truth be told the doctors didn’t much care for it either. In fact I had one doctor who never in the many years I was his patient perform the procedure. Shame on him and shame on me for not insisting on the exam.
So when I found out that a new test had been approved which requirement a simple blood test, I was happy. No longer would I have to “assume the position”. However I should point out that the digital exam is still used and is a viable test that should be used along with the PSA blood test.
There is however one major problem with testing PSA levels and that is false positives. False positives happen when for a variety of reason you have a high PSA level, but no cancer. There are several reasons for a high PSA which have nothing to do with cancer. Certain medicines such as finasteride and dutasteride can increase PSA. Also urinary infections can cause a rise in PSA. Even different labs can give different results.
PSA is a double edge sword on one hand it can detect evidence of prostate cancer, but on the other a false positive can mean a man might undergo a prostate biopsy needlessly. There is even a lot of debate about frequency of the testing, at what age should testing begin and what is an acceptable PSA level above which a person should undergo further testing.
In my case I went the middle ground. When my test results showed a rise in my PSA above 4.0, I after conferring with my doctor decide to wait (Watchful Waiting) three months and then take another PSA test. Unfortunately for me my PSA continued to rise and I had a biopsy which verified the presence of cancer.
The bottom line here is to be knowledgeable about these tests and to confer with your doctor. Because prostate cancer is in most cases a slow growth type of cancer no decisions need to be made immediately. I would encourage anyone who has a PSA level above 4.0 to wait three months and be tested again. However an extremely high PSA could indicate an advance cancer. It’s important to have regular checkups and PSA testing in order to establish a baseline for you and your doctor.