PSA Test Remains a Viable Tool – For Now
A statement from the PCF in response to recent studies regarding PSA tests

Thursday, Sep. 3 (PCF) -- This week’s online publication (Journal of the National Cancer Institute, August 31, 2009) of new data from a study conducted by researchers at Dartmouth Medical School’s Institute for Health Policy and Clinical Practice, once again calls into question the validity of PSA screening as a tool for diagnosing and treating prostate cancer.

On one side of the debate is the problem of overtreating and exposing a large number of men who have a non-lethal form of the cancer to unnecessary side effects and anxiety. On the other hand, the PSA test, as one tool in the diagnostic process, has helped to save more than 50,000 lives.

The valid criticism of the PSA test is that it is not a cancer-specific marker. It acts as a smoke alarm, indicating that there is a problem—either cancer or another condition—in the prostate that needs further assessment. Supplemental tests including the digital rectal exam and a needle biopsy may result in a diagnosis of cancer. But the question remains: which type does a man have? Is it the lethal prostate cancer that can lead to his death? Or, is it the indolent, non-life-threatening variety that poses little threat?  

In prostate cancer, simply having the ability to distinguish between lethal and non-lethal varieties could have saved an estimated $40 billion dollars during nearly two decades (1986-2005) by avoiding overtreatment, and saved thousands of lives by directing intensive care to those who needed it most.

One of the vital areas of continuing research supported by the Prostate Cancer Foundation is discovering new biomarkers that will enable healthcare professionals to specifically diagnose prostate cancer and to differentiate between the life-threatening and non-lethal varieties.

Every man has the right to know if he has cancer, including prostate cancer. Until we have a better biomarker, the PSA remains a viable and valuable tool. It is just not the only tool a patient and his doctor need to make treatment decisions. If given a diagnosis of prostate cancer, every man is also entitled to have a full understanding of the risks and benefits of either deciding to treat the cancer or opt for active surveillance.