Prostate cancer is one of the most common cancers affecting men, especially as we age. According to Prostate Cancer UK 1 in 8 men will be diagnosed with prostate cancer in their lifetime. Two significant events have combined this mouth, both raising awareness of prostate cancer and making many people who have prostate glands consider whether they should screen themselves with a Prostate Specific Antigen (PSA) test.
Firstly, it's Movember. As you look around you may have noticed many men attempting to grow moustaches to raise awareness and money for charitable projects related to prostate & testicular cancer.
And secondly, the incredibly sad news that the 48 year old olympic cycling legend, Sir Chris Hoy, has been diagnosed with terminal prostate cancer. He has shared his moving story; Finding Hope with Sally Nugent on the BBC's 5 Live and has called for earlier screening for prostate cancer to be considered.
In the UK, the NHS offers PSA testing as part of the Prostate Cancer Risk Management Programme (PCRMP) for men aged 50 and older, but you may be surprisinged to learn that it’s not a routine screening programme. The Health and Social Care Secretary, Wes Streeting, has asked the NHS to “look at the case for lowering the screening age on prostate cancer,” particularly for people with a family history of the disease, after comments made by the Olympic cyclist Chris Hoy.
Currently the NHS recommends that men proactively ask their GP about the test rather than waiting for an invitation. The idea of this approach ensures that men receive balanced information about the potential outcomes, including possible follow-up tests if PSA levels are elevated. The UK National Screening Committee doesn't currently recommend screening for prostate cancer with PSA tests because it says it is unclear if the benefits outweigh the harms. It is due to review this decision in the next 12 months.
Yet, early detection and monitoring can significantly improve outcomes, making screening a powerful tool in managing men’s health. Here’s what men need to know about the importance of screening, when to start considering it, and what to expect from the process.
Prostate cancer screening can be a life-saving tool, but it’s also a deeply personal decision. The PSA test, isn’t perfect, so understanding its benefits and limitations is key to making an informed choice.
What is the PSA Test, and How Does It Work?
The PSA test measures the level of prostate-specific antigen, a protein produced by both cancerous and noncancerous prostate cells. Higher-than-normal PSA levels in the blood can indicate prostate cancer but can also result from other conditions, like benign prostatic hyperplasia (BPH) or infections. Additionally, PSA levels can vary with age, prostate size, and medications, which is why doctors consider multiple factors when interpreting PSA results
Key Factors to Consider for PSA Screening
Age and Risk Factors.
Age significantly impacts prostate cancer risk, with most cases occurring in men over 50. Risk is also elevated in Black men and those with a family history of prostate cancer or gene mutations like BRCA1 or BRCA2. These individuals might consider screening as early as 40-45.
Pros and Cons of PSA Testing.
The PSA test has its strengths and weaknesses. On the plus side, PSA screening can detect prostate cancer early, often before symptoms arise. Early treatment may prevent the cancer from spreading, making it easier to treat and potentially lowering the need for aggressive treatment with side effects like incontinence and erectile dysfunction.
However, not all prostate cancers are aggressive; some grow so slowly that they may never pose a significant health threat. Screening may also lead to false positives, unnecessary stress, or treatments with side effects that impact quality of life. False negatives, though less common, are also possible and can create a false sense of security
Personal Preferences and Shared Decision-Making
For many men, the decision to screen comes down to personal preference. If knowing your PSA levels and staying vigilant offers peace of mind, then screening might be worth it. However, if the potential for overdiagnosis or the stress of dealing with an indolent cancer outweighs the benefits for you, then you may decide to forgo screening. A conversation with your doctor is essential to help weigh these factors and tailor the approach to your health goals.
Final Thoughts
Prostate cancer screening is a tool that, when used thoughtfully, can make a significant difference. However, deciding whether to pursue a PSA test should involve careful consideration of your risk factors, lifestyle, and feelings about potential outcomes. By discussing your concerns with your doctor, you can make an informed choice that aligns with your values and health priorities.
Myself, I have joined in with the Movember movement with my work colleagues and Sir Chris Hoy's story has encouraged me to arrange a Medstars PSA test.
Dr Barry Lambert.
Co-Founder
Comentários