More Accurate Detection Of Prostate Cancer

According to a new Harris Interactive survey of 1,000 men, more than half expressed concern over the accuracy of current prostate cancer tests.

Today, the two most common methods for detecting prostate cancer are the digital rectal exam (DRE) and prostate-specific antigen (PSA) blood test. These screening tools are most effective when used in combination.

Abnormal PSA tests cannot be used to provide an absolute diagnosis of prostate cancer because the PSA test measures the level of a protein that is not specific to prostate cancer. For example, abnormal PSA tests are often found with a common noncancerous condition known as benign prostatic hyperplasia and may also be caused by other noncancerous conditions such as an inflamed prostate, which is treatable with antibiotics.

After an abnormal PSA test result, a doctor may order a follow-up test, such as a prostate biopsy, or recommend a "wait and see" approach, which repeats the DRE and PSA tests regularly to watch for changes.

"The DRE and PSA screening tools have been important in reducing the number of prostate cancer deaths each year," said Dr. Paul Lange, chairman of the Department of Urology at the University of Washington and author of Prostate Cancer for Dummies. "However, because follow-up tests must be performed after an abnormal DRE or PSA test, there remains a degree of uncertainty, which can lead to patient anxiety."

Once prostate cancer is detected and diagnosed, men face a choice between the "wait and see" approach and treatment, which can affect quality of life. In fact, the survey found that 80 percent of men would be concerned about the effect of prostate cancer treatment on their sex lives.

"A diagnosis of cancer can turn a patient's life upside down and men want to know that they are receiving the most accurate information available when it comes to prostate cancer detection," added Dr. Lange. "A new urine test is being developed that may be able to detect prostate cancer with improved accuracy."

Gen-Probe, a San Diego-based diagnostics company, is currently developing this urine test, which looks for genetic changes specific to prostate cancer. By looking at these changes, doctors may have a more specific method to detect prostate cancer. This new test, used in combination with DRE and PSA, may greatly improve early detection and diagnosis of prostate cancer.

The American Cancer Society recommends that men be tested every year for prostate cancer beginning at age 50. However, if a patient has a family history of prostate cancer or if he is African American, it is recommended that annual testing begin at age 40. It is believed that early detection of prostate cancer will increase the chance for survival.