The PSA Test – Who Should Get It?

The PSA Test – Who Should Get It?


When it comes to determining what cancer has become the most common for American men and which is the second leading cause of cancer deaths, one needs to look no further than prostate cancer.

Prostate Cancer Statistics

The numbers are staggering as it is likely to develop in 126.1 men per 100,000 and it is extremely likely to develop in Hispanic men. There are about 21.8 deaths per 100,000 men due to prostate cancer, including being the second most leading cause of death in white, black, American Indian/Alaska Native and Hispanic men, while also being the fourth leading cause of death for Asian/Pacific Islander men.

Should You Get Checked with PSA Test?

These staggering numbers would make one think that it should be an obvious thing for men to get checked early, but in fact, it is quite the contrary. The prostate-specific antigen test, or PSA, is one of the most controversial topics in the health industry. The PSA test is a blood test that scans your blood for a certain and specific protein that is produced only in the prostate organ. When the test comes back, the higher the number of PSA found means that the person is likelier to have prostate cancer.

After the test comes back and shows elevated levels of PSA, a biopsy should be taken from their prostate and examined. This process in itself doesn’t sound pleasant, as 12 needles are inserted into the prostate with the help of an ultra sound, and these needles pull the samples.

When the test was first identified as a way of helping men fight back against prostate cancer, it was a major step in the right direction for at-risk men. Before the test was introduced, just being diagnosed with prostate cancer meant your life was over, but now, with the PSA test, 16 percent of men are diagnosed and about three percent eventually pass away from the cancer.

The Argument

It sounds pretty simple in theory to get the PSA test if you are at risk, but here is where there is a problem and where the health care companies have an issue. The majority of tumors that are found in prostates are not large enough to warrant getting the treatment. There has been some research done on the matter and some put a number of 40 percent of men that get the positive diagnosis having a cancer that is too slow in growth to become deadly. When you get the diagnosis, there are various treatments including radiation, surgery and biopsies that can be performed, but these all pose serious side effects including incontinence, impotence and in the most severe cases, death.

The argument here is that if the cancer is too slow to become deadly, getting it treated with these methods could post a more serious health risk to your body than allowing the cancer cells to remain in your body. Many might automatically assume that they would want their cancer to be diagnosed, which is the case with cancer like pancreatic or lung, but the number of men diagnosed with prostate cancer that is not lethal would mean they are better off not knowing.

Government Suggestions 

The American government thinks it would be better for healthy, symptom-free men to not get the PSA test. The United States Preventative Services Task Force suggested in their May 2012 guidelines that only men experiencing the symptoms should get the PSA test. Previously, they had said only men over the age of 75 should not get the test performed.

On the opposite side of the American government’s stance on this subject, there are many experts that feel that the PSA test should still be used. If the PSA test wasn’t used, the only other way to determine if you have prostate cancer would be the traditional rectal exam. This exam is performed in the office of your doctor and they check your prostate with their finger. This method can help the doctors discover some tumors, but in many cases, tumors are left undiagnosed until it is too late to fight back.

Dr. Herbert Lepor is the Martin Spatz Chairman of the department of urology at NYU Langone Medical Center in New York and he feels that the PSA test should still be used, but patients need to be screened better before getting it. He suggests giving the PSA test and then completing the test again to confirm the PSA levels. If the second test confirms the results, then doctors will be able to use an advanced MRI scan to locate the tumor, rather than going in blindly with a biopsy. Lepor says that if the PSA test consistently shows the same PSA levels, the patient might not need to get a biopsy unless they have a family history of the cancer.

The main idea behind the whole argument against every patient getting the PSA test is to be able to identify the cancers that need treatment and those that treatment might not be necessary. 

>Learn More About Prostate Cancer Risks 

>Learn More About the Seven Steps to a Health Prostate


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