Prostate Specific Antigen – Inaccurate Blood Test Versus Lifesaving Screening Tool

Posted on

Aug 22, 2013

Book/Edition

Florida - Southwest

Share This
Prostate cancer screening has received a greatdeal of press over the past decade or two. The introduction of the prostate specific antigen blood test (PSA) in the late 80s has resulted in a significant number of prostate cancers being diagnosed at early clinical stages. In fact, each year over 250,000 cases of prostate cancer are diagnosed in the United States alone and over 40,000 men die of this disease annually. Early diagnosis IS key.
Current knowledge on how to use PSA values to determine which men need urological evaluation is vitally important to primary care providers, especially when dealing with healthy males between the ages of 40 and 80 years of age.
It was once considered standard of care to interpret any PSA reading between zero and 4.0ng/dl as normal. Fluctuations within this range were given little if any significance.
In addition, levels as high as 6.5ng/dl were even considered acceptable in men over the age of 70 at one time. Using these parameters was successful in minimizing the over diagnosis of prostate cancer in elderly males with clinically insignificant prostate cancers.
Unfortunately, many younger patients with mare aggressive cancers were left undiagnosed until they had non-organ-confined disease, which negatively impacts cure rates as well as morbidity of treatment.
In addition to the total PSA blood test, free PSA testing may be used to increase the specificity of a borderline or high PSA result (4-l0ng/dl). Free PSA is reported as a percentage of the total PSA, and represents the fraction of serum PSA that is unbound to a carrier protein. Patients with prostate cancer have less free PSA.
The following guidelines represent the current standard for interpreting PSA values in the screening of men for prostate cancer.
It is important to include in this discussion the necessity of the digital rectal exam, which if abnormal must be evaluated, regardless of the PSA result: PSA levels over 2.0ng/dl in males under the age of 50 and PSA levels over 2.5ng/dl in males under the age of 60 should be considered abnormal.
PSA levels over 4.0ng/dl should always be considered abnormal and warrant urological evaluation.
An increase in PSA (PSA velocity) or O.7ng/dl over an IS-month time span should be considered significant. even if within normal range for PSA (0-4ng/dl).
Free PSA levels below 10% indicate at significant risk for prostate cancer.
PSA levels should be considered inaccurate if obtained in the presence of a urinary tract infection, prostatitis or after a traumatic Foley catheter placement. A period of four to six weeks after treatment should be sufficient to allow the PSA to return to baseline.
Editors Note: Article provided by Dr. Gurevitch of Specialist in Urology, 239-434-6300.

Other Articles You May Like

Lung Cancer Screening: What You Need to Know

Early detection of lung cancer increases your odds of successful treatment and celebrating more birthdays. But a lung cancer screening comes with a few risks, too. So, should you get checked?The American Cancer Society, American Lung Association and the U.S. Preventive Services Task Force (USPSTF) say yes if you meet certain criteria tied to long-time cigarette use.Lets take a closer look at your options with pulmonologist Peter Mazzone, MD, MPH.Who should get a lung cancer screening?A lung cancer screening isnt for everyone, states Dr. Mazzone. Its recommended only for adults who are at high risk for the disease which explains why screening guidelines are pretty specific.The USPSTF suggests an annual lung cancer screening if all of the following apply:  Youre between age 50 and 80.Youve smoked at least 20 pack-years of cigarettes. (To calculate pack-years, multiply the average number of packs smoked per day by the number of years you smoked. So, 20 pack-years is one pack a day for 20 years or two packs a day for 10 years).You currently smoke or have quit smoking within the past 15 years.Its also important that youre healthy enough to benefit from finding and treating early-stage lung cancer. People who get tested dont typically have symptoms of lung cancer.If someone comes to us in a wheelchair already wearing oxygen and couldnt tolerate treatment, they typically arent eligible for screening, clarifies Dr. Mazzone. However, there are nearly 15 million Americans who are at high risk and should receive screening.It should be noted, too, that a lung cancer screening is a quick and painless imaging exam. It uses low-dose computed tomography, or low-dose CT, to capture very detailed pictures of your lungs.Why is lung cancer screening important?As noted, lung cancer often doesnt announce itself with early symptoms. So, without an annual screening, lung cancer is often detected once the disease has progressed and spread which makes successful treatment less likely.People with lung cancer have about an 80% chance of being alive five years later if the cancer is diagnosed and treatment begins during Stage 1. The five-year survival rate is about 4% if tumors have spread.That leads us to this alarming reality: Only about 1 in 4 people with lung cancer are diagnosed before the cancer spreads. Early detection is key to changing that, says Dr. Mazzone.Are lung cancer screenings perfect? Of course not. Scans sometimes detect small spots called nodules that look concerning but are basically harmless little scars. Radiation exposure is a concern, too. Ditto for overdiagnosis of conditions and additional testing and stress.But the benefits of lung cancer screening still outweigh any potential harm for many people, notes Dr. Mazzone.How often is lung cancer found during a screening?Lung cancer is found in about 1 in every 140 people who get screened. This may sound like a small number, but its about the same or better than the results for breast cancer and colon cancer screening.How to decide whether to get a lung screening?A counseling session is often required before a lung cancer screening so you can discuss lung cancer risks, the screening process, benefits and potential harm. It can be a complex and difficult decision for people to make.Many people value the potential benefit of screening so much theyre happy to accept them, explains Dr. Mazzone. Others may have a different perspective. Talk to your doctor to help decide whats best for you.And because the test is annual, the decision on whether to do it can be revisited every year.This article was written by Lungs, Breathing and Allergy Team from Cleveland Clinic and was legally licensed through the DiveMarketplace by Industry Dive.Contact Blue Cross and Blue Shield of Alabama for your medicare and health insurance needs. Contact them at 251-344-2115

You might be done with school, but you still need to take some testS

Working adults and retirees may be far removed from school and the stresses that come with high-stakes testing.No matter our age, though, were not done taking tests. Unlike the pop quiz in English literature, algebra or world history, the tests we take as older adults are some of the most important exams in our lives.Colorectal cancer is one of the most common cancers and the second-most common cause of cancer death in the U.S. and  worldwide. The American Cancer Society estimates that two-thirds of colorectal cancer deaths occur in patients over 65. However, if caught early, cancer of the colon is highly treatable and often curable.In 2021, the U.S. Preventive Services Task Force lowered the recommended testing age for colorectal cancer from 50 to 45 due to an increase in its incidence among younger individuals. Gen Xers, Baby Boomers and older generations who are up to date on their testing likely have already completed a colonoscopy, the gold standard of testing for this dangerous cancer. This screening test is highly important because colorectal cancer often doesnt have symptoms in the initial stages.The screening uses a scope to look for polyps, a small clump of cells that forms on the lining of the colon. Most colon polyps are harmless, but some can become cancerous. When cancer forms in a polyp, it grows into the wall of the colon and eventually can spread to distant parts of the body. During a colonoscopy, the doctor can remove colorectal polyps to help prevent cancer.While the test itself is done under general anesthesia, the preparation for a colonoscopy is often what people dislike. To make sure doctors can see polyps, the colon must be clean and empty before the procedure. That means everything in your bowel must go, which is accomplished by drinking large volumes of water mixed with a laxative the day before, and sometimes the morning before, the procedure. The liquid results in diarrhea and considerable time in the bathroom as your colon is cleared. You will also be on a clear-liquid diet the day of the procedure.The preparation can be unpleasant. Perhaps that is why four in 10 Americans aged 45 and older are not up to date on their colorectal cancer screenings, according to the American Cancer Society.But there is good news. People who dont have other risk factors generally only need to have a colonoscopy every 10 years. Also, a lot has changed in recent years. Today, the preparation liquid (often a gallon) does not need to be consumed in one sitting and may be taken the night before and the next morning, making it more tolerable. The solutions are also better-tasting than they once were.Also, there are some alternatives, including lower-volume solutions and a pill prep involving 12 tablets taken twice with large amounts of water. In addition, the FDA has approved three types of stool tests to screen for colorectal cancer at home. They should be completed every one to three years. If a stool test is positive, which doesnt always mean cancer is present, a follow up colonoscopy is necessary.   There are things we can do to prepare for a colonoscopy to make the preparation less unpleasant:         The less you have in your stomach before colonoscopy preparation, the easier it will be. Start eating smaller portions and reducing fiber five to seven days in advance.         The week before a colonoscopy, avoid nuts and seeds, popcorn, red meat, raw vegetables, corn, peas, broccoli, cabbage, dried beans, whole grain bread and pasta, brown or wild rice, fruit with skins, fried foods and cereals like oatmeal, shredded wheat and granola.          Chill any liquid preparation, as it is often easier to drink when its cold.         Use a straw to bypass the tastebuds in your mouth as you drink the preparation.         Suck on lemon slices or sugar-free menthol candy while you drink or after each sip to help with the taste.         Mix in sugar-free water flavorings that are clear, not red, blue or purple.         If nausea was an issue during a previous preparation, ask your doctor for anti-nausea medicine in advance. While age is a risk factor for developing colorectal cancer, increasing physical activity, maintaining a healthy weight, not smoking and limiting alcohol can reduce the risk of developing colorectal and other cancers. Even if you were inactive in your younger years, becoming active when you are older can lower your risk.Your primary care doctor can help you keep track of preventive services, like screening tests and vaccines, as well as help make lifestyle recommendations such as diet and exercise to help reduce risk for illness.About the AuthorJaimenee Jaime Khemraj is chief medical officer for Healthcare Network, which has practices throughout Collier County offering family care, dental care and pharmacy as well as behavioral health counseling. For more information, visit HealthcareSWFL.org, or to schedule an appointment, please call 239-658-3000. 

Early Detection of Colorectal Cancer Can Save Your Life

Early Detection of Colorectal Cancer Can Save Your LifeColorectal cancer, sometimes referred to as colon cancer, is one of the leading causes of cancer-related deaths in the United States, but with early detection and proper treatment, it can be prevented and managed. March is Colorectal Cancer Awareness Month, and at Assisting Hands Home Care, we want to spread awareness and educate the public on the importance of screening and early detection.Colorectal cancer begins in the colon or rectum and can spread to other parts of the body if not detected early. The good news is that colorectal cancer can often be prevented with regular screening and detected early through screening tests such as colonoscopies. The American Cancer Society recommends that people at average risk of colorectal cancer start regular screening at age 45 and continue until age 75.Symptoms of colon cancer can include changes in bowel habits, rectal bleeding, abdominal pain, weakness, and fatigue. If you experience any of these symptoms, seeing a doctor promptly is important.There are several risk factors that can increase the chances of developing colon cancer, including age, family history of colorectal cancer, personal history of colorectal polyps, a personal history of inflammatory bowel disease, and lifestyle factors such as a diet high in red and processed meats and low in fruits and vegetables, as well as physical inactivity and smoking.To reduce the risk of colon cancer, medical experts often recommend a diet low in animal fats and high in fruits, vegetables, and whole grains to reduce the risk of other chronic diseases, such as coronary artery disease and diabetes.According to the NIH, a significant association was observed between high nut consumption and a reduction in colorectal cancer among women (in those with an intake of 3 servings of nuts per week compared to those that declared no nut consumption).Some studies suggest that people may reduce their risk of developing colon cancer by increasing physical activity, keeping a healthy weight, limiting alcohol consumption, and avoiding tobacco. For more information on reducing your risk, visit the CDC website.At Assisting Hands Home Care, we understand the importance of early detection and management of colorectal cancer. Our trained and compassionate care providers are available to assist with transportation to and from doctor appointments and provide support during recovery from any necessary treatments. We also offer assistance with daily activities such as meal preparation and housekeeping, allowing our clients to focus on their health and recovery.In conclusion, colorectal cancer is a serious health concern, but regular screening and early detection can prevent and manage it. At Assisting Hands, we are committed to educating and supporting our clients and their families on the importance of colorectal cancer awareness and early detection. If you or a loved one is in need of support and assistance during a cancer journey, contact us today to learn more about our in-home care services.To find an Assisting Hands location near you, visit https://assistinghands.com/location-finder/