PSA: The Continuing Controversy

By Rebecca Jones

Ever since the U.S. Preventive Services Task Force announced their recommendation that healthy men shouldn’t get PSA blood tests to screen for prostate cancer the health community has been in a state of fierce debate.

After examining all the evidence, the task force was able to find little to no evidence that routine PSA screening caused a reduction of prostate cancer deaths and in many cases caused men to pursue treatment that caused more harm than good. PSA stands for prostate-specific antigens; a simple blood test is conducted to see if these antigens are present in the blood stream. The problem right now is that a high level of these PSA’s does not necessarily signify prostate cancer; it can also indicate an infection, an enlarged prostate or small tumors that would never become cancerous. Many doctors however say that when it comes to treating cancer early detection is the best way to reduce fatalities and that the idea that finding cancer early can do more harm than good is a hard one to swallow.

This debate takes on a very personal note for those who have or have known a friend or loved one that has battled with prostate cancer. However the evidence remains, for most biopsies, conducted after an abnormal PSA, the results come back noncancerous. In men where small tumors are found it was discovered that in 2 out of 5 cases these tumors would never have become deadly and yet in treating them, via radiation or surgery, men are exposed to serious side effects like incontinence, impotence or other potentially fatal complications.

While there are risks involved in treating tumors unnecessarily, doctors maintain that prostate cancer poses a real risk to men’s health stating that 1 in 6 men will develop it at some point in their lives. Each year in the U.S. 217,000 men are diagnosed and another 32,000 die from this disease. It seems unconscionable to them to stop screening in healthy men all together.

Luckily this is just a recommendation and a lot of good can come from saying that the existing test is not as effective as it needs to be. Voices from both sides of the debate are calling for a more effective screening test, one that could distinguish between aggressive cancers and more benign tumors. While men who are at risk or have symptoms would not be affected by this recommendation it is important that we continue to find better ways to detect all types of cancer, prostate included.