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With recent public awareness initiatives prostatic cancer is something that is on a lot of people’s minds and when someone presents to us with bone pain it’s one of those things, on a long mental list, that you like to draw a line through. Many men have had a PSA test come back that seems to indicate that there might be reason for concern but recent comments and studies have shown that the PSA test should not be given as much credence as it has been to date.

In fact the creator of the blood test used to detect prostate cancer has admitted it has become a “hugely expensive public health disaster” and should be abandoned.

Richard Ablin, who developed the prostate-specific antigen test 40 years ago, used by about 1 million Australians a year yesterday agreed it had been proven inaccurate and was “hardly more effective than a coin toss”. ”PSA testing can’t detect prostate cancer, and more important, it can’t distinguish between the two types of prostate cancer – the one that will kill you and the one that won’t,” Dr Ablin wrote in a column in the The New York Times.

An American survey of 77,000 men concluded there was no decrease in the death rate in those who had yearly tests compared with those who were not offered testing. In the European trial, involving 182,000 men, it was found the death rate did decline slightly but 48 men would need to be treated to save one life.

“We now have a situation where there is over diagnosis and over treatment,” the chief executive of the Cancer Council Australia, Ian Olver, said.
What is the prostate-specific antigen (PSA) test?

Prostate-specific antigen (PSA) is a protein produced by cells of the prostate gland . The PSA test measures the level of PSA in the blood. The doctor takes a blood sample, and the amount of PSA is measured in a laboratory. Because PSA is produced by the body and can be used to detect disease, it is sometimes called a biological marker or a tumor marker.

It is normal for men to have a low level of PSA in their blood; however prostate or benign (not cancerous) conditions can increase a man’s PSA level. As men age, both benign prostate conditions and prostate cancer become more common. The most frequent benign prostate conditions are prostatitis (inflammation of the prostate) and benign prostatic hyperplasia  (BPH) (enlargement of the prosta;te). There is no evidence that prostatitis or BPH causes cancer, but it is possible for a man to have one or both of these conditions and to develop prostate cancer as well.
A man’s PSA level alone does not give doctors enough information to distinguish between benign prostate conditions and cancer. However, the doctor will take the result of the PSA test into account when deciding whether to check further for signs of prostate cancer.
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