The Hidden Truth: What PSA Testing Won't Tell You

Prostate-specific antigen (PSA) testing is a common screening method for prostate cancer, involving a blood test that measures the level of PSA, a protein produced by both normal and malignant cells of the prostate gland. While PSA testing can be a useful tool in detecting prostate cancer, it has limitations and cannot provide a complete picture on its own. Here are several crucial aspects that PSA testing won't tell you:

1. Cancer Aggressiveness
   • PSA testing cannot determine how aggressive a detected prostate cancer might be. High PSA levels can indicate the presence of cancer, but they don't reveal whether the cancer is slow-growing and likely to remain localized, or fast-growing and likely to spread. This distinction is critical for deciding on the urgency and type of treatment.
2. Cause of Elevated PSA levels
   • Elevated PSA levels do not exclusively indicate cancer. Other conditions such as benign prostatic hyperplasia (BPH), prostatitis (inflammation of the prostate), or even recent activities like cycling or ejaculation can raise PSA levels. Consequently, a high PSA result can lead to unnecessary worry and further invasive tests like biopsies, which have their own risks and complications.
3. Cancer Location and Size
   • A PSA test does not provide information about the location, size, or extent of the tumor. Imaging tests like MRI or CT scans and physical examinations (such as a digital rectal exam) are necessary to gain a better understanding of the tumor's characteristics and to plan appropriate treatment.
4. Future Cancer Development
   • A normal PSA level does not guarantee that you will not develop prostate cancer in the future. Some men with prostate cancer have PSA levels within the normal range. Therefore, regular monitoring and additional screening methods might still be necessary, especially for those at higher risk.
5. Patient’s Overall Health Impact
   • PSA testing does not consider the overall health and life expectancy of the patient. For older men or those with significant comorbidities, the potential benefits of early cancer detection might not outweigh the risks of treatment. Understanding the patient's overall health status is crucial in making informed decisions about screening and treatment.

Other Factors to Consider

• Over diagnosis and Overtreatment: Another downside of PSA testing is the risk of over diagnosis and overtreatment. Over diagnosis refers to the detection of cancers that would not have caused symptoms or harm during a man's lifetime. This often leads to overtreatment, where men undergo surgery, radiation, or hormone therapy that can result in side effects like urinary incontinence, erectile dysfunction, and bowel problems. Many men might endure these treatments unnecessarily due to the inability of PSA tests to identify which cancers are life-threatening.
• Lack of Comprehensive Risk Assessment: PSA testing provides a snapshot of prostate health but does not offer a comprehensive risk assessment. Factors like family history, genetic predispositions, race, and lifestyle are crucial in understanding an individual’s risk of prostate cancer. A holistic approach, incorporating these elements, is necessary for a more accurate risk assessment and personalized screening strategy.

Recognize the Limits

While PSA testing can be a valuable tool in the early detection of prostate cancer, it is important to recognize its limitations. It cannot tell you everything about the presence, nature, or future risk of prostate cancer. A comprehensive approach that includes additional diagnostic tests, consideration of individual risk factors, and a thorough discussion with a healthcare provider is essential for making informed decisions about prostate cancer screening and treatment.

Why Choose Us

BASS Cancer Center houses a diverse team of medical experts, including renowned oncologists, social workers, coordinators, counselors, and education specialists. We utilize advanced PET/CT imaging technology, such as the Biograph 6, and innovative treatments like the MRI-guided MRIdian system. This system allows for precise radiation therapy with simultaneous imaging, minimizing harm to healthy tissue. Additionally, we employ the Elekta Versa HD for advanced imaging and motion management during treatment.

If you'd like to learn more about PSA testing, rely on the expertise of our team. Contact us today for a consultation to discover how we can assist you.