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7 months ago
Prostate cancer screening might not be necessary for all, says expert

Men, once they cross 50 years of age are advised to go for a PSA test annually to keep a tab on their prostate health. PSA (prostate-specific antigen) test is usually done to assess the health of the prostate gland. With age, the prostate gland enlarges and leads to various problems. While enlarged prostate is not an alarming condition but a sign of ageing, it is better to keep a tab on how the gland is progressing to check if there is a risk of developing prostate cancer in future. Here are reasons why prostate is considered a silent killer.

Often there is no early symptom of prostate cancer. Most of the time the prostate cancers are diagnosed when advanced. Prostate-specific antigen screening can diagnose prostate cancer early. However, recently experts have become concerned about these screening tests being done without consultation with an expert like an oncologist or a urologist. ‘It is good to take preventive measures, but to ask every man after 50 to go for a prostate screening isn’t necessary,’ says Dr Avinash Deo, Consultant Medical Oncologist, S L Raheja Hospital.

Even the U.S. Preventive Services Task Force (USPSTF) recommends against prostate-specific antigen (PSA)—based screening for prostate cancer as it does more harm than good. ‘If it is just the PSA which is a blood test, it is still fine but screening test followed by confirmatory biopsy can lead to complications like bleeding, infections, etc. Most of the time some cancers are low grade and slow growing which does no harm if left untouched. This is a reason it is believed that everyone may not benefit from screening. One must discuss the pros and cons of screening with one’s doctor before undergoing the test.

Prostate cancer can be ascertained by a PSA marker at times, but it could also be elevated due to a urine infection or other unknown causes like benign enlargement of the prostate. Even healthy men can have elevated PSA levels. However, a reading of 4 ng/ml can make your doctor suspicious. Studies have shown that PSA levels that range between 2.9 to 4 ng/ml indicate that the cancer is confined to the organ and have lower progression rate [1]. ‘This is why if the PSA test turns to be suspicious it is necessary to talk to an oncologist or a urologist before undergoing a biopsy. Sometimes it could be due to a benign tumour,’ says Dr Deo.

The benefit of early diagnosis is uncertain so the efforts to treat prostate cancer have focused on developing new drugs. Newer therapies include chemotherapy, hormonal manipulation and the use of radioisotopes and therapeutic vaccinations are in use.

Reference:

Zhu H, Roehl KA, Antenor JA, Catalona WJ. Biopsy of men with PSA level of 2.6 to 4.0 ng/mL associated with favorable pathologic features and PSA progression rate: a preliminary analysis. Urology. 2005 Sep;66(3):547-51. PubMed PMID:16140075.

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