2009 PSA Testing Guidelines from AUA
PSA testing has become one of the most controversial issues in health. Many men routinely undergo the blood test to try to spot prostate cancer early. There's no question the screening can do that, but many doctors have begun to challenge routine PSA testing because it often leads to unnecessary biopsies and treatment for a cancer that may never be life-threatening. Prostate cancer is often so slow growing that it never actually causes problems. Two major studies released last month fueled doubts about PSA testing when they failed to find clear evidence it reduced the chances of dying from prostate cancer.
But the American Urological Association begs to differ in its updated recommendations on PSA testing released Monday. The guidelines say PSA testing can be very useful in spotting cancer early and helping men and their doctors make decisions. The guidelines lower the age that it says doctors should offer it to men from 50 to 40.
The key, the guidelines say, is how the results are used. For example, the other big change the guidelines recommend is how the results are interpreted. Instead of doing a biopsy simply when the PSA level goes above a certain level, the guidelines say the PSA "velocity" is more important. That's how fast the PSA level is rising. If a man's PSA rises very quickly over a short period of time, the guidelines say, that's when a biopsy may be necessary.
But the American Urological Association begs to differ in its updated recommendations on PSA testing released Monday. The guidelines say PSA testing can be very useful in spotting cancer early and helping men and their doctors make decisions. The guidelines lower the age that it says doctors should offer it to men from 50 to 40.
The key, the guidelines say, is how the results are used. For example, the other big change the guidelines recommend is how the results are interpreted. Instead of doing a biopsy simply when the PSA level goes above a certain level, the guidelines say the PSA "velocity" is more important. That's how fast the PSA level is rising. If a man's PSA rises very quickly over a short period of time, the guidelines say, that's when a biopsy may be necessary.
Labels: from the literature
posted by Connie Schardt at
8:27 AM
1 Comments:
It is absolutely necessary that a patient be given enough information to be able to make an informed decision about whether to undergo diagnostic testing (such as a biopsy) when a high PSA is detected or a digital examination finds an abnormallity with the prostate gland. The same goes for treatment (such as surgery) once the presence of cancer is confirmed by a biopsy.
While a biopsy carries certain risks a "watchful waiting" approach also carries risk. Here the risk is that the cancer will actually spread before a biopsy is finally performed. Regrettably, I have had clients whose cancer was not caught until it had spread outside the prostate gland during the time that lapsed as their doctor either did not order a PSA examination as per the guidelines or did not inform the patient about a rising PSA.
We may never know how many of the thousands of men who die each year of prostate cancer could have successfully treated their cancer if they had been diagnosed earlier. It can be a very unpleasant way to die. I, for one, have my doctor screen me for cancer every year.
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