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PSA prostate cancer screening and its accuracy

Updated on June 19, 2013

Most people dread the thought of them or their loved ones going through any type of cancer. This is because it is quite a devastating illness. Prostate cancer is a type of cancer common in older men that are over the age of fifty. It occurs in the male reproductive system, in a gland known as the prostate gland. However at times when it is particularly aggressive it can spread from this gland to other areas of the body. This is a process known as metastasizeation, which can cause the effects of the cancer to be extremely severe.

The Prostate Gland

The prostate gland is an organ in the male reproductive organ located in front of the rectum right under the bladder. The prostate gland consists of glandular and muscular tissue and is about the size of a chestnut. It’s hugely beneficial in the male reproductive system. This is because it emits a milky alkaline secretion that is delivered into the urethra during semen emission.

The purpose of this secretion, also known as prostatic fluid, is to enhance the chances of survival of sperm in order to contribute to procreation. Hence it goes without saying that this organ is crucial when it comes to the fertility of a man

So how does this work? Essentially sperm is at its best as concerns mobility if it is in an alkaline solution. However the fluid that emanates from the semen vesicles and the testes is acidic. Hence in the acidic solution the sperm is minimally mobile, and this ultimately affects how successful the sperm will be at getting to the female egg and ending up in the conception of a child. Apart from playing a significant role in a man’s sexual functions the prostate is also extremely crucial when it comes to bladder control.

The prostate gland keeps growing as one gets older. During infancy, this organ is the size of a pea. By the time, the boy gets to be a young adult it has grown to be the size of a walnut. When a man gets to his late forties, this organ gets enlarged from its normal walnut size. This is caused by rapid growth at the center of the prostate gland.

Benign Prostatic Hypertrophy(BPH)

Hence the older a man gets the more they are likely to have issues with their prostate. For example, an enlarged prostate gland can be the source of a lot of discomfort and inconveniences. It is also referred to as BPH. This is an acronym for benign prostatic hypertrophy. Its manifests itself by causing problems during urination. This includes producing a weak stream of urine or feeling like urinating all the time even after one has just urinated. This is common in older men who have attained the age of fifty and above.

However men with fifty years and below can also experience prostate problems. The commonest of this is Prostatitis. This is where there is inflammation or irritation of the prostate gland. It causes one to urinate more often or experience burning while urinating. This may be due to bacteria, kidney stones and in the most severe cases Prostate cancer.

When one is suffering from prostate cancer, cells in the prostate gland go out of control. This can cause urinary discomfort, pain, erectile dysfunction or problems while performing sexual intercourse among others. It is not easy to detect, but early detection and immediate treatment, provides a bigger chances of beating the disease.

Prostate Cancer

Prostate cancer is caused by the growth of malignant cancerous cells in the gland. This is also known as a tumour. In most cases, it grows slowly and keeps to the prostate gland which can be over many years. It is creeps up on an individual as it shows little outward symptoms if any. It’s good to note that there are different types of prostate cancer and some are quite aggressive.

Worldwide, prostate cancer is more developed in the developed countries and is about the sixth leading cause of death. However, the rates of prostate cancer are increasingly becoming common in the developing world. This is thought to be the commonest form of cancer in men second to skin and lung cancer. The good news is that only one in thirty five men die from it. This means it is controllable and curable.

Treatments for Prostate Cancer

Treatments for prostate cancer include chemotherapy, radiation, and surgery and hormone therapy among others. As science evolves, better ways are coming up of treating prostate cancer, and this has significantly increased the survival rate. Early diagnosis is crucial when it comes to improving one's chance of surviving prostate cancer. In addition to this, the type of test done to diagnose the problem is also vital.

It is recommended that from as early as forty years of age men should undergo frequent screenings for this ailment. No one can exclude themselves from the list as this disease can be caused by different things. These include hormonal influence, lifestyle, and exposure to toxins, genetics, diet and even the fact that one is aging. By the nature of the disease, it is quite common in much older men at the ages of 65 to 80 years of age.

Symptoms of this illness include a lump in the gland, abnormality in a blood sample, burning while urinating and blood in the urine among others. Although these symptoms are not unique to prostate cancer, it is advisable for one to go for testing. This is to confirm that they are indeed prostate cancer free.

Tests done to check for Prostate Cancer

Some of the tests done to check for prostate cancer include the PSA test and the digital rectal examination. New and better ways of diagnosing prostate cancer are coming up with each passing day as science develops. The best way to beat prostate cancer is to diagnose it early and get immediate treatment for it. Hence the significance of testing cannot be underrated.

The digital rectal examination is exactly as it sounds. It is an examination of the rectum using the digital finger. This is done by asking the individual to stay in a position which makes it easy to insert the finger into the anus. This varies and one may choose to lie in a fetal position, bend over or squat.

Once the patient is comfortable the doctor checks for external abnormalities first. These may include rashes or bumps around the anus and perineum. This is then followed by the physician slipping a gloved index finger into the rectum feeling the prostate organ for any abnormalities. The benefits if this exam is that it can also help discover other illnesses such as fistula of the anus or rectum and cancers of the anus and rectum among others.

The other is the PSA test or Prostate – specific antigen blood test. This test measures the amount of prostate specific antigen in the blood stream. This antigen is also referred to as the gamma-seminoprotein and is secreted by the epithelial cells located in the prostate gland. Epithelial cells are essential when it comes to secretion of substances, transcellular transportation and detection of sensations in organs among other benefits.

Hence it is not surprising that the PSA helps in male ejaculation. This is done by liquefying semen sufficiently enough to allow sperm to swim properly. It also helps the sperm to have an easier passage into the uterus by dissolving cervical mucus.

The PSA test is fairly straightforward. A qualified medical practitioner uses an elastic band to force the patient’s veins to engorge with blood. This is done by tightly wrapping the elastic band around the arm of the patient. Blood is then drawn from any of the most prominent veins.

So why is it used to test for the presence or lack of prostate cancer? It is used because normally PSA is found to be in low levels in the serum secreted by men with healthy prostate glands. However when there is a problem with this gland these levels become elevated. It is necessary to note that unusually high levels of PSA can also denote other health issues.

High PSA levels

One of the reasons for high levels of the Prostate –specific antigen protein in men apart from prostate cancer is if the man is suffering from Prostatitis. This is because this disease can cause a number of conditions that may lead to inflammation in the prostate. Hence there are different types of prostatitis chronic bacterial prostatitis, acute bacterial prostatitis, asymptomatic inflammatory prostatitis and chronic pelvic pain syndrome. In all of these instances, antigens that are produced by the inflamed cells resulting from the diseases can trigger an increase in PSA levels in the individual’s blood.

Ironically, age is not only a factor when it comes to getting prostate cancer, but it is also a problem when it comes to detecting it when using the PSA test. This is because as a matter of course the older a man gets the higher his PSA levels get.

Another explanation for high levels of PSA in a man is if he has recently undergone a prostate biopsy. This is a medical test that involves the removal of small samples from the prostate gland to test for the presence of cancerous cells. What happens is that there may be inflammation caused by the removal of tissue samples which will result in elevated levels of PSA.

The other possibly reason for increasing PSA levels could be where the man is suffering from Benign Prostatic Hyperplasia which is a condition common to older men whose prostate grows due to age. As the prostate becomes larger it presses against the man’s urethra.This in turn, presses against the bladder, resulting in frequent urination. However, this is not the only drawback of the ailment as it also causes inflammation of the prostate. This causes production of PSA levels that when a test is done will seem to be elevated.

Surprising enough certain perfectly normal medical tests can also interfere with the accuracy of a PSA test. The DRE test is a good example. This is because it involves touching the prostate gland through the rectum. Just touching the gland leads to an increase in PSA levels. Hence one should avoid taking a DRE test right before having a PSA test.

How medication interferes with PSA levels in the body

Medication can also be a cause of elevated levels of PSA. One of these is Methotrexate, which is an anti metabolite medication. It can be used in the treatment of some cancers as well as ailments such as rheumatoid arthritis and psoriasis among others. This medication has been known to affect the levels of PSA in the body by increasing or decreasing the count. Hence people on such medication would give conflicting results when it comes to testing for prostate cancer.

Another type of medication, which can affect PSA levels in one’s body, is Cyclophosphamide. This is used in the treatment of different types of cancer and some autoimmune diseases. The liver converts it into active forms that may have a chemotherapeutic effect in the body which is why it is used in conjunction with other chemotherapeutic agents for treatment of cancers. It can also decrease the response of the immune system to different diseases, and this is why it is used certain forms of autoimmune diseases where certain forms of treatment have been ineffective. However despite its usefulness in combating the stated diseases, it can cause an increase in PSA levels. This can end up affecting any test done for this antigen.

It is also possible for people taking Viagra or Cialis to help in sexual activity it can also indirectly affect PSA levels in the body. If a PSA test is done within 48 hours of a patient experiencing an ejaculation, then the results may indicate an increased level of PSA. This result is indirectly caused by the use of Viagra or Cialis medication. Hence it is advisable for one to be thoroughly open with ones doctor whenever going for the test right down to being honest about any medication they are using for any complication.

Herbs that distort PSA levels

Apart from conventional medicine certain herbs can also distort the levels of PSA in an individual. Some herbs are considered to be beneficial when it comes to controlling prostate problems.This includes dealing with issues such as frequent urination or even dealing with certain illnesses such as Benign Prostatic Hyperplasia. Reasons for this would be an attempt to reduce medical expenses because certain herbs are much cheaper and the body reacts better to using them, as well. However these herbs can end up impairing the accuracy of a PSA test.

However these herbs normally referred to as natural supplements may not be as harmless as they seem. They are sometimes promoted as being good for optimum prostate health and are not regulated by the FDA. As long as they do not claim to heal certain diseases they are allowed. Whereas, some of them are quite effective and good for dealing with prostate problems, they may end up impairing the results of a PSA test. Nature can be a great ally when it comes to dealing with Prostate Cancer.

Why use herbs and supplements with caution when dealing with Prostate Cancer

Herbs and supplements are seen to be a safe option by most people. So why do they end up being part of the things that one should avoid when it comes to a PSA test? First off is that although they claim to be natural they still have medicinal properties that may end up affecting different processes in the body. Since they are not FDA, approved they are not rigorously tested scientifically as are the drugs approved by this regulatory body. The lack of regulation leads to another problem which is that contents from one batch to the other may vary.

Different companies may also produce the same herbal supplement but with variations in content. So once a patient is taking a supplement for an ailment it may end up having varying effects. Hence making ones doctor aware of exactly what herbs and supplements one is using is therefore ,quite necessary. Some of these herbs include Saw Palmetto and PC – SPES among others.

Activities that can affect PSA levels in men

In addition to this certain activity can end up having an effect on ones PSA levels. It is believed that riding a motorcycle or bicycle could be one of activities to avoid should one be going for this test. This is because they end up causing pressure on the prostate which may end up affecting the levels of the PSA.

If an individual undergo an injury in the prostate area prior to the PSA test, then it will produce unreliable results. This is because the area may be inflamed which will end up causing the PSA level to rise. If a patient is given a PSA test at this time, then it will give unreliable results.

The physical state of the patient can also affect the PSA test. If one is obese, then the results may end up being unreliable. It has been discovered that men who are obese, generally have lower PSA levels, than men with an average weight. Hence detecting cancer in such men proves to be difficult sometimes resulting in the diagnosis being done when the cancer is too far gone. This is counterproductive as the earlier prostate cancer is detected and treatment started the better the chances of fast recovery for the patient.

With all these factors at play when it comes to determining the accuracy of a PSA test then using it becomes an unreliable affair. Hence there is ongoing research on how to change the way it is done in order to ensure reliable results or find a way of combining it with other tests. This helps to ensure that the test results whatever the case are deemed accurate.

Unreliability of PSA tests

It’s necessary to understand the effects of an unreliable PSA test. For starters, it leads to unnecessary treatments. Unfortunately, many men end up being wrongly diagnosed for prostate cancer. This leads to unnecessary mental anguish for men as well as the wrongful use of finances towards treatment. In addition to this treatment options chosen may end up being extremely harrowing for the patient. This pain and anguish is all unnecessary and could be avoided if reliable tests are used in the first place.

The main issue with PSA tests is that of over diagnosing. This is because most of the cancers deemed to be exceedingly serious may ultimately end up being tame. It also means that there are many men undergoing unnecessary aggressive treatment for prostate cancer when it is unnecessary because the cancer does not warrant it. It is much better to try an alternative treatment method.

However, there are men who are convinced that they should get a PSA test and take the results seriously in spite of the risk of being over diagnosed or wrongly diagnosed when it comes to prostate cancer. For this kind of person, it is advisable to take the test regularly but adopt a ‘watchful waiting’ form of treatment. This is in case of low risk cancer detection. This defers the use of aggressive treatments for as long as possible while giving the doctor a chance to monitor the way the cancer is behaving.

Tests done on this kind of approach have indicated that treatment was deferred until it was necessary which has proved to be quite a substantial amount of time. Some men have had to undergo treatment up to eight years after their prostate cancer diagnosis. Ultimately there was about the same percentage of cancer survival whether there was immediate aggressive treatment after diagnosis or a watchful waiting approach was adopted. The benefit of choosing alternative methods to deal with Prostate cancer such as watchful waiting mentioned above.

There is also the option of combining PSA testing with other forms of testing in order to come up with results that are extremely reliable. One approach that could be considered is taking a short course of certain drugs to ensure the results of the PSA test are reliable. For example, a drug known as Finasteride has been identified. It is normally used to deal with prostate enlargement problems. However it has also been used to aid in making sure that results of a PSA test are reliable.

With the daily advancement of modern science, there are also better bio markers being identified for use when it comes to testing for prostate cancer. A biomarker is a substance from the body which can be used to test for the presence of an ailment or dysfunction in the body. This involves identifying certain substances in the body which can be used in accurately testing for the disease. In the meantime patients can only use the available options albeit with c


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    • JenIncognito profile image

      JenIncognito 4 years ago

      My husband is a survivor of prostate cancer. He had it surgically removed a few years ago and has been blessed with it not coming back. Depending on the choice of treatment, men can change after this surgery but if a couple faces it together, with love, the relationship can blossom and grow.