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To PSA Test Or Not to PSA
Test - That Is the Question

"Finding solid info about PSA tests can sure be frustrating," admitted Frank Homsy with a shake of the head. "For example, when trying to get up to speed about PSA testing, I ran across these two headlines at the library:

"US study in the Archives of Internal Medicine found the PSA test failed to reduce deaths".

"Annual PSA screening cuts the risk of dying from prostate cancer by more than two-thirds, a new study concludes. "

Hmm. Both can't be right.

"Reading further," Homsy went on, "I learned PSA tests are often inaccurate and can lead to unnecessary biopsies because the elevated PSA returned is really a false positive."

"On top of that I found out that both benign prostatic hyperplasia (BPH) and chronic prostatitis can affect PSA levels in your blood."

"What's an average guy like me supposed to conclude?"

Frank's right. Like many things in medicine, rather than being black and white, the PSA test is seen by some to be more of a gray area. That doesn't mean you shouldn't have it done, it just means you need to realize it's limitations.

Besides, don't you think doctors would love to have a simple prostate specific antigen test threshold that's easy to remember? So that when a patient's PSA testing returns a reading above that, it's signaling that it's time to order up a biopsy.

Unfortunately there is no such trip wire.

Which is why rather than looking for a given number, many cancer specialists place more importance on a rapidly rising PSA level. To them that is more of an alarm bell than one given read. Which is why it's probably a good idea to develop a benchmark in your late 40s and then get an annual PSA test done so you can keep an eye on the trend yourself.