Healthbeat Report: Prostate testing

June 7, 2012 (CHICAGO)

Early detection can be a key in preventing deaths and while there's confusion about whether the common prostate specific antigen (PSA) test does more harm than good, more accurate tests may be available soon.

Prostate cancer is typically a slow growing tumor. Most men with the disease will actually die of other causes never knowing they had the cancer.

The problem is that it usually causes no symptoms until it is advanced and when it begins to grow rapidly it is dangerous.

"Mine was a more aggressive form or appeared to be a more aggressive form of prostate cancer," said patient Dan Zenka.

A PSA test is what most men get to determine their risk.

Zenka found out he had prostate cancer through the next generation of tests, a pro PSA test.

PSA is found in the blood and high levels could indicate cancer.

The new test measures three different levels in the blood. Combined with annual biopsies it was 70 percent accurate in singling out tumors.

"It can give you a more accurate estimate of whether or not he has prostate cancer," said Dr. William Catalona, urologist at Northwestern Medicine.

Meanwhile, researchers at the University of Michigan believe a new urine test is more accurate.

"PSA, you have to understand, stands for prostate specific antigen," said Dr. John T. Wei. "It actually is not specific for cancer. So when your doctor says it abnormal, it could be because you have an enlarged prostate, prostate inflammation or cancer."

The urine test works by identifying gene fusions that occur when pieces of two chromosomes stick together.

These fusions are common in prostate cancer. The urine test identified 80 percent of patients with it.

"It's going to make my life easier, if not put me out of business," Dr. Wei said.

The newer tests have not yet been approved for use in the United States, but the option men now have is coming under intense fire.

A government panel says healthy men should not get routine prostate cancer screenings.

Updated advice from the U.S. Preventive Services Task Force claims PSA blood tests do more harm than good leading to unnecessary surgeries and treatments, which can cause devastating side effects.

Could a new and more accurate test put an end to the confusion? Possibly, but other researchers say it's not yet time to abandon what we have.

"Clearly doing away with PSA all together is a bad idea in my mind and I strongly disagree with the preventive services task force," said urologic oncologist Dr. Scott Eggener from University of Chicago Medical Center.

Dr. Eggener is not alone. There are many doctors advising men not to give up on the standard PSA test just yet.

It may be imperfect, but advocates believe it still saves lives.

Dr. Eggener, who has studied the use of PSA screening, said choosing the right patient is key.

"The PSA test is the best test we have currently but it is not perfect," he said. "We as doctors and patients individually need to do a better job of deciding who is most likely to benefit from a PSA and who is less likely and we can test them less frequently or not test them at all."

Dr. Eggener is known to be an expert in the field of prostate cancer he is also related to an ABC 7 producer.

Right now the pro PSA test is awaiting FDA approval. It's already being used in Europe.

Meanwhile, the American Cancer Society says at age 50, men should start to talk to their doctor about the pros and cons of testing.

Pro PSA Test

Dr. John Wei

Dr. Scott Eggener
University of Chicago Medicine

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