Cancer screening, cancer diagnosis
If you are 50 years of age or older, male and living in the West, you will almost certainly be offered a PSA test at your annual check up.
However, if you are 50 years or more and living in the West, there is a very good chance you will have an enlarged non-malignant prostate (termed benign prostatic hyperplasia). This carries with it certain symptoms, which are virtually identical to those of prostate cancer.
The UK charity, The Prostate Cancer Charity, defines them as:
- Difficulty or pain when passing urine
- The need to pass urine more often
- Broken sleep due to the need to pass urine
- Waiting for long periods before the urine flows
- The feeling that the bladder has not completely emptied.
With prostate cancer you may also suffer from blood in the urine, and/or lower back pain and/or dribbling. But be aware that many of the above symptoms can be caused by other factors e.g. bacterial infection.
Your doctor can simply feel if you have an enlarged prostate (a digital rectal examination). If he finds such an enlargement he will probably send you for a PSA test (prostate-specific antigen). This measures a specific protein in a man’s blood, the level of which was thought to correlate with prostate cancer.
However, this test has been found to be seriously flawed. Several top cancer experts in the USA feel it is ’worthless’. You can have a high reading from an enlarged non-cancerous prostate, or if you have had a high dairy consumption, vigorous exercise, or even just ridden a bicycle in the previous 24 hours! Taking lycopene can even lower the score!
The test does not seem to fully distinguish between enlarged malignant prostates and non-malignant ones, and one USA report concluded that as many as two thirds of those testing positive, probably are not!
Over-diagnosis is a real concern. Roughly 12 per cent of males told they have prostate cancer after PSA testing do not have it at all.
Never just have a single test, but three to six across a two month period.
A new test has already been through Clinical Trials at Sloan-Kettering in the USA and been cleared by the FDA it measures the levels of circulating tumour cells (CTC’s) and is applicable to breast and colorectal cancers too. The test may well be incorporated into treatment programmes in the future so that the effectiveness of your chemotherapy can be more accurately monitored.
Read our article on Prostate cancer if you are concerned. And remember: NEVER BE RUSHED INTO TREATMENT. 50 per cent of prostate cancers are very slow growing are just require ’active surveillance’. As many as 90 per cent of all prostate cancers are slow growing. Only those in men below 40 are usually quick growing.