There seems to be no prostate
cancer test that is 100% accurate, but the PSA (prostate
specific antigen) test seems to be the best that is
available at present. However, there are two PSA tests that
need to be done. In addition to the standard PSA test, you
should have a “Free PSA” test. The Free PSA test determines
the percentage of total PSA that is not associated with a
tumor. Many physicians use a rule that the Free PSA number
should be equal to or greater than 25% of your total PSA
test. If it is not, there is a significant likelihood that
a tumor is present. [Note: Dr. Patrick Walsh at Johns
Hopkins in Baltimore, Maryland, notes that Free PSA scores
of less than 15% tend to indicate aggressive tumors.¹]
For example, if your total
PSA is 3.0, your Free PSA should be equal to or greater
than .75. In my case, my total PSA was 3.2, well within the
“acceptable” range of “less than 4.0,” and no tumor could
be felt by digital rectal exam. However, my Free PSA was
only 9% (.09), far less than the 25% benchmark. Two sets of
needle biopsies revealed a tumor located on the top portion
of the prostate where it could not be felt during a digital
rectal exam. Post-surgery examination of the prostate
revealed three separate tumors.
It’s important to know these
numbers. If you haven’t had a Free PSA test, ask your
physician to order one. There always is the chance of a
false positive (or a false negative), but further tests can
rule out a tumor before other treatment. If you are
uncomfortable in discussing this with your physician, take
someone with you. The consequences of metastasized prostate
cancer are pretty dire. Know those numbers!
Note:
I am not a physician so I
cannot and am not providing medical advice. I am, however,
relating my personal opinion base on personal experience
over the past four years as a prostate cancer survivor. I
will be posting additional information on my own personal
research and experience in the blog page.
¹ Dr. Patrick Walsh’s Guide to Surviving Prostate Cancer,
Warner Books, Walsh, Patrick C., M.D., New York, NY, 2001.