PSA Test Critical Tool for Prostate Cancer Diagnosis Despite Criticism
Canadian advocates for PSA blood testing say it remains a critical diagnostic tool for prostate cancer despite criticism emerging from the United States that it may do more harm than good.
Last week, a U.S. government panel of scientists said routine PSA testing doesn't lead to an appreciable reduction in deaths.
Furthermore, the group said the tests can lead to biopsies that turn out to be false alarms, or treatments that can leave men incontinent or impotent for non-fatal cancers.
Steve Jones, president and CEO of Prostate Cancer Canada, said while PSA testing isn't the be-all, end-all in diagnostic tools -- it can't, on its own, prove the presence of cancer -- it's the best available test for men 40 and up.
"Every few months there is a study that comes out that is negative about PSA testing," Jones said Thursday at a Prostate Cancer Canada meeting in Halifax.
"All we know is that we listen to our survivors and virtually all of them here have said in some way PSA testing is the red flag that saved their lives."
Elevated levels of PSA, or prostate-specific antigen, in the blood aren't necessarily caused by prostate cancer. Too much PSA can also be caused by the normal enlargement of the prostate with age, an infection, or recent sex.
"What men use the PSA test for -- a very simple blood test -- is to raise a warning flag that says there may be something wrong here," continued Jones.
"But also remember: doctors aren't advising every man to get further testing. When they have their PSA test, if the levels are up, they then check their family history, diet, all the other signs that may lead to prostate cancer."
Olivia Chow, the widow of former federal NDP leader Jack Layton, addressed the conference Thursday, urging men to get tested in hopes of detecting prostate cancer early.
Layton was diagnosed last year with prostate cancer. He died in August of a second cancer that was never disclosed.
Chow told the crowd that her husband was "relentless" in his campaign for others to seek PSA testing, even before his diagnosis of prostate cancer.
"Jack took the PSA blood test every year because his father had prostate cancer and he knew that he was at risk," she said.
Chow also echoed Prostate Cancer Canada's calls for PSA testing to be covered across Canada.
Jones said some provinces, including Nova Scotia, pay for the test. However, in provinces such as Ontario, he said men have to pay out of pocket for the test without a doctor's referral.
"The onus is on the governments to understand that men shouldn't have to pay for a PSA test just as women don't have to pay for a mammogram," he said.
Draft recommendations by the American panel, meanwhile, say PSA blood tests should no longer be part of routine screening for healthy men.
The panel's stance goes against past advice by some advocacy groups and urologists. It also goes further than previous messages from the American Cancer Society, which advises men to decide for themselves after hearing the pros and cons of PSA testing.
But for Peter Mallette of Halifax, there's no doubt of the benefits of PSA testing.
His first-ever PSA test at the age of 48 led to further tests and a diagnosis of prostate cancer. Within five weeks of the initial blood work, surgeons had removed his prostate gland.
Now, Mallette is cancer-free.
"I think the PSA test saved my life," said Mallette, now 54, the director of Prostate Cancer Canada's Atlantic office.
"Statistically we know that if prostate cancer is detected early, it is almost always curable."
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