THE PSA PUZZLE
The prostate-specific antigen (PSA) is an enzyme made by the prostate gland. Medical specialists have recommended the PSA blood test for all men 40 and older since 1988. The test was designed to detect prostate cancer through an early evaluation of PSA scores. The normal PSA level for most men is considered to be less than 4.O and men under the age of 40 should have a PSA count fewer than 2.7. When a PSA score mysteriously raises beyond the norm your oncologist usually recommends a biopsy to search for prostate cancer. The dreaded needle biopsy creates an environment of fear, worry and emotional trauma for the recipient until the final results are in. For many men the rush to have painful biopsies has proved to be negative even when they have had an elevated PSA reading.
Today, there is research that proves that having a high or positive PSA test result could be a false indication of something less severe than cancer. For older men who have enlarged prostates (BPH) or inflammation and infection of the prostate (prostatitis) can dramatically elevate the PSA. Also calcium deposits in the prostate gland can raise the PSA. Because of these new findings a count of 6.O to 10.O may be considered normal for those of us over 40. In other words there is no “normal” or “abnormal” PSA level that can apply to everyone. Even more confusing, it has been reported that temporary increases in PSA levels may be caused by ejaculation within 24 hours before the test, digital rectal examination or prostate biopsy before the test. That might mean that men with a high PSA reading may not have cancer cells lurking within their prostate gland.
Recently, researchers at the Dana-Farber Cancer Institute at Harvard Medical School in a review of years of research have documented that 50 percent of ALL MEN with high PSA scores don’t have prostate cancer. A similar study was recently reviewed in the British Medical Journal.
There is also a flipside to this mass confusion. PSA tests have shown men to have healthy prostates but when they underwent biopsies they tested positive for cancer. As one prominent doctor put it, “ Don’t rely on a PSA test to tell you whether or not you have prostate cancer.”
So, if a high PSA score is not the enemy, is it the messenger? Unfortunately, maybe it is both. Tanya Harter Pierce, author of Outsmart Your Cancer reported on Dr. John R. Lee and his remarkable study and research on the real functioning of the PSA. In Hormone Balance for Men, Dr. Lee explains that first of all, the PSA is not something that only cancerous cells produce. In fact, Dr. Lee states that PSA is produced in large part by normal healthy cells of the prostate gland. They produce PSA simply in response to crowding (or pressure). This is why an infection or any type of inflammation in the prostate gland will generally cause a rise in a man’s PSA production. If Dr. Lee is correct then can we say that the PSA test is a marker of inflammation and not cancer? Maybe – but maybe not.