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Health Watch

Prostate Cancer - 6/19/2008

All About Prostate Cancer

Prostate cancer is the most common cancer in males, ranking as the second most common cause of cancer-related deaths in men older than 50 years of age. Prostate cancers are often clinically silent and cause no symptoms, particularly during their early stages.

"Can prostate cancer be found early?"

"YES, prostate cancer can be detected early", says Dr. Nelson Lim, Medical Director of Hi-Precision Diagnostics (HPD). According to him, prostate cancer can often be found through digital rectal exam (DRE), transrectal ultrasound, or by testing the amount of prostate specific antigen (PSA) in the blood. Since the use of these early detection tests for prostate cancer became fairly common, the death rate has dropped, but it has not been proven yet that this is a direct result of screening.

According to Dr. Lim, most healthcare professionals recommend that PSA blood test and DRE be done yearly, beginning at age 50. Initially, physicians will do a DRE on the patient, and if any findings are noted, such as an enlarged prostate or a feel of any bumps or hard areas, a blood screening for PSA is usually requested. A PSA level of >4 ng/L usually signifies a problem in the prostate gland. Dr. Lim however, added that there are still limits to these current screening methods. Neither the PSA test nor the DRE is 100% accurate. Aside from prostate cancer, PSA may also increase as a result of an injury, after sexual activity (ejaculation), inflammation of the prostate gland (prostatitis), benign prostatic hyperplasia (BPH) (enlargement of the prostate). On the other hand, there are also some medications and herbal mixtures that may falsely lower PSA levels.

Uncertain or false test results could cause confusion and anxiety. Some men might have to still undergo biopsy, carrying all the risks, along with the feeling of discomfort, just to confirm the diagnosis of prostatic cancer, when in fact cancer is not present. On the other hand, others might get a false sense of security from normal test results when cancer is actually present.

With the advancing technology, newer methods and techniques are continuously developed to further improve the quality of life. And Hi-Precision Diagnostics supports this mission to humanity. In addition to the traditional PSA testing, a newer test, the free prostatic specific antigen (fPSA), is available at HPD for the screening of prostatic cancer. fPSA is also a form of PSA that is found in the blood. The percentage of fPSA is lower in men with prostate cancer than in men who do not have the disease. According to Dr. Lim, fPSA offers a greater level of specificity in identifying early prostate cancer. He also added that the fPSA testing was already approved by the U.S. FDA as a diagnostic aid for men with PSA values falling between 4 - 10 ng/L and this can be used to help decide if a patient still needs to undergo a prostate biopsy. In this case, fPSA may aid in the analysis of cancer risk.

If a patient’s total PSA value falls within the 4 - 10 ng/L, fPSA can be requested. A low percent-fPSA means the likelihood of having prostate cancer is higher and the patient should probably need a biopsy to confirm the diagnosis. Many doctors recommend biopsies for men whose percent-fPSA is 10% or less, and advise that men consider biopsy if it is between 10% and 25 %. By using these cut-off values, most cancers are detected while helping some men avoid unnecessary prostate biopsies.

Until more information is available, whether the patient will have the tests is something for him and the doctor to decide.

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