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November 08, 2011

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PSA is short for Prostate Specific Antigen. An antigen is a substance that promotes the development of antibodies. When antibodies are being produced, it means that there is some unwanted process occurring, which, in the case of the prostate, would be an unregulated proliferation of cells more commonly known as a tumor. Therefore, if PSA levels are increased beyond a certain amount, it is fairly certain that cancer nastiness is right around the corner.
It's a cheap test that involves drawing a few extra milliliters of blood. In all probability, the chemical analysis of the blood is automated and costs practically nothing. The PSA test is trivial, but an elevated PSA level is not.
Physicians these days take every opportunity to investigate borderline blood chemistry results. They refuse to take any chances - they want to know why certain components of the blood are elevated. My own doctor completely turned my life upside down last year when he refused to give me clearance for surgery because I had borderline high levels of "monocytes" in my blood. A high monocyte level is most often associated with leukemia, and it cost $8000 for a bone marrow biopsy to find out that I did not have leukemia. That little exercise delayed my surgery for six months. My new doctor recently reviewed my medical records and told me that I have had high monocyte levels for many years. Go figure.
High PSA levels are not 100 percent indicative of cancer, but it puts a fellow in that undesirable neighborhood. There does not seem to be a valid reason to immediately jump into biopsies based upon borderline results.

Willie R, not only are you correct that high PSA levels are not 100 percent indicative of answer, the situation is much more uncertain than that.

As mentioned in this post, 80% of tests that come back with a high PSA level are false positives. Meaning, the patient doesn't have a tumor. So 4 times out of 5, the PSA test is wrong.

All these diagnostics and tests can be a blessing or a curse as Willie R demonstrated.

Prostate cancer is usually slow growing and can remain localized in the gland itself. (this is not to say there are not aggressive prostate cancers).

If you get a high PSA reading or even a diagnosis of cancer, chances are you will live another 20 years or so without any action being taken. If you are 60 or 70 years old that puts you at about the end of your life anyway.

So, I say ignore the test and live 'till you die.

Oh, you say you want to live to be 100? Have you ever seen a centenarian whose health condition you envied?

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