Several years ago my husband noticed that the need to go to the bathroom was becoming frequent and urgent. That started our journey into the world of the prostate. The prostate is a gland in the male reproductive system. It sits below the bladder. It’s the organ that makes some parts of the fluid in semen.
He started by finding a doctor. For this part of your anatomy you will be looking for the specialty of urology. He’s on his second doctor and is fairly comfortable with him. The urologist ordered what is called a PSA test. The prostate specific antigen (PSA) test measures how much PSA is in the blood. When my husband first got tested his PSA level was off the charts at 11. It turned out that he had an infection called prostatitis which was cured with an antibiotic.
PSA is measured by nanograms or millimeter of blood. A normal number is under 4 so you can imagine our panic at 11 especially when we read and read that if your level is between 4 and 10 there is a one in four chance you have prostate cancer. If your number is over 10 than you’re looking at a 50 to 50 chance!
My husband has had PSA tests yearly. Samples of his prostate are removed in what he describes as a very uncomfortable procedure. He has an enlarged prostate. There is no question about that. An enlarged prostate however doesn’t mean one has cancer.
His numbers have never been below 4 thus he’s had 3 soon to be 4 biopsies. His PSA level just came back at 6.
In 1998 the Federal Drug Administration approved a new test. The purpose of this test called the Hybritech free PSA test (fPSA) is to cut down on men getting biopsies that aren’t necessary. As a woman I compare it to a mammogram. First I have a mammogram. Then if there is a question I have an ultrasound or a needle biopsy. That procedure has cut down on the number of surgeries performed (on me anyway!).
The Hybritech free PSA test was developed by Beckman Coulter. It finds 95% of prostate cancers. Most prostate cancer that are found early, just like breast cancer, before it has spread outside the prostate is curable and need not be a death sentence.
My husband’s doctor did a free PSA test at the same time he did the usual PSA test. The hope was that it would come back under 20%.
Clinical trials were done at seven hospitals including Washington University School of Medicine and Harvard University. The lead researcher, Dr. Catalona, stated, “Our research findings indicate that this test can help physicians more precisely detect prostate cancer in its early stage.” He went on to say that “Prostate cancer is expected to kill more than 39,000 American men this year, according to the American Cancer Society.”
The way it works is that a high percentage of free PSA correlates with a low risk of cancer. So you want to get back a number higher than 25%. If you do you only have an 8% chance of having prostate cancer. If your number is 0 to 10% you then you have a 56% chance of having cancer. My husband’s number is 21%. That puts him right on the line of having a 16 to 20% chance of having cancer.
Prostate cancer is the most common type of cancer found in American men. Lung cancer is the first. The American Cancer Society estimates that over 200,000 new cases of prostate cancer will be discovered this year in the United States. Over 27,000 men will die of prostate cancer this year. The death rate for prostate cancer is going down, and the disease is being found earlier thanks to tests such as the free PSA test. If you are a man over 50 (or talk with your doctor if you have a family history of prostate cancer) I urge you to get your PSA level tested. That is just a blood test. It may save your life!
Source: Catalona WJ, et al. “Use of the percentage of free prostate specific antigen to enhance differentiation of prostate cancer from benign prostatic diseases. A prospective multicenter clinical trial.” JAMA, 279:1542-1547, 1998.