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Pattaya Daily News

21 April 2011 :: 11:04:42 am 52972

Is the PSA the savior of mankind?

Prostate cancer is common, something we men have to live with. After all, our women are always telling us how lucky we are to be men and not have to go through childbirth for example, so it’s probably only right that there is a male downside. In fact this year in the United States, almost 180,000 men will be told that they have prostate cancer. That’s 180,000 downsides.
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The statistics show that by age 50, almost 50 percent of American men will have microscopic signs of prostate cancer. By age 75, almost 75 percent of men will have some cancerous changes in their prostate glands. Do the maths. By the time we are 100 we’ve all got it!

So does this mean that life really ends at around 76? Fortunately no. While the numbers quoted above look fearsome, the real situation is not quite so bad. A much smaller number of men will actually be treated for prostate cancer. About 16 percent will be diagnosed with prostate cancer during their lives; 8 percent will develop significant symptoms; but only 3 percent will die of the disease. Put another much more positive way, 97 percent won’t die from prostate cancer.

So let’s look at diagnosis and get the “blood test” out of the way first. The blood test is called Prostate Specific Antigen, or PSA for short. Up till then we had another test called DRE (digital rectal examination), which, quite frankly, was not all that popular. As medical students, we were taught “If you don’t put your finger in it, you’ll put your foot in it!” Despite this, ‘buyer resistance’ was high, so when news came through about a “blood test”, millions of men began rejoicing and the sale of rubber gloves plummeted.

Unfortunately, PSA is not a go/no-go test. A normal range test doesn’t guarantee you haven’t got it, and an elevated result doesn’t automatically mean that you are about to claim early on your life insurance (or your dependants, anyway).

However, there is good news. We are becoming smarter with the PSA test. Elevated PSA levels in the blood correlate roughly with the volume of cancer in the prostate, with the stage and grade of the tumor, and with the presence or absence of cancer metastases or growths in other tissues. Serial PSA examinations can also show the rate of this growth, another good reason for regular check-ups.

‘Staging’ has four main grades. Stage I cannot be felt and is diagnosed through pathological testing. Stage II can be felt, but it is confined to the prostate. Stage III is coming out of the gland and Stage IV has grown into nearby tissues.

‘Treatment can be ‘watch and wait’, surgery, radiation, or hormone therapy. Often it will be a combination of some of the above. This is where you need to discuss your options with your doctor. If you are a young man with stage IV, then you have to make up your mind quickly. But if you are 75 with stage I or II, then you have more time, as you will most likely die of other causes before the prostate cancer gets you.

Watch and wait has much going for it, but you must be prepared to get to know your urologist on first name terms. You will be seeing a lot of him over the years, so pick a young one with good English!

by Dr.Iain Corness

Photo : Internet   Category : Health

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