There is a lot of talk in the media currently about prostate cancer and getting tested, but what does this actually mean? Even amongst medical professionals, prostate cancer screening isn’t always well understood. There are many complexities that need to be considered before a test is performed and it’s important to discuss these before a test is done. At Urology Clinics Manchester, we have international experts in the diagnosis and management of prostate cancer available to discuss your prostate health and the options available to you.
The most commonly performed ‘test’ for prostate cancer is the PSA (Prostate Specific Antigen) blood test. PSA is a chemical produced by prostate cells and is easily measured on a blood sample. Many people believe that a PSA test will tell you if you have a prostate cancer or not, but, unfortunately, it isn’t quite as simple as that. All prostate tissue produces PSA (not just cancerous tissue) and the more prostate tissue a man has, the higher his PSA will be. Every prostate grows throughout a man’s life, so the older a man gets, the bigger their prostate will be and, therefore, the higher their PSA result. Equally, some people have big hands, some have big feet and some men will have a big prostate! It’s very important to correlate the size of a prostate with the PSA, as the ratio of the gland size to PSA gives a good idea of the chance of there being a problem. There are also several things that can temporarily increase a PSA, such as urinary infections, exercise and even sex! It’s important that these factors are considered before a PSA is checked, because they could affect how a result is interpreted and cause unnecessary concerns.
One of the other problems with PSA testing is that even when prostate cancer is identified, PSA testing alone isn’t enough to tell us what type of cancer it is. Prostate cancers vary from low-grade, low-risk tumours that never cause problems to more aggressive tumours that need treatment. Testing everyone’s PSA might lead to the identification of many more prostate cancers, but many of these will be low- grade cancers that would never have caused harm and identifying them may cause more problems than we prevent – this is the reason why men aren’t routinely offered PSAs in the same way we do for breast or cervical screening. It is possible that in the future combining PSA testing and MRI scanning may make it easier to identify tumours that will cause problems without exposing men to invasive investigations, but research into this area is ongoing and it isn’t certain yet.
However, there is increasing evidence that PSA testing is useful in men who are at risk of developing significant prostate cancers. Men who have a father, brother or uncle diagnosed under the age of 65 are at increased risk of getting a cancer themselves. A family history of breast or ovarian cancer at a young age, particularly related to the BRCA gene, also increases the risk of prostate cancer. We also know that men of African or Afro-Caribbean heritage and men from the Ashkenazi Jewish community are at a higher risk of being found to have prostate cancer and are more likely to have cancer that requires treatment. If you are in one of these at-risk groups, we’d normally recommend annual PSA testing from the age of 45 and there are some other genetic tests that could be considered too.
If you’d like to discuss your individual risk of prostate cancer and the merits of screening and genetic assessments, at Urology Clinics Manchester, we’re happy to help. We have a number of international experts in prostate cancer management available at sites across Manchester and Cheshire and offer cutting-edge diagnostics and treatments, so get in touch.
Find out more at :
Web : urologyclinics.co.uk
Email : info@urologyclinics.co.uk
