Prostate Cancer Testing Pros and Cons
Dr. Phranq D. Tamburri discusses the standards of testing
The recommended standard for testing of prostate cancer, which is the second most common cancer in men, is to have a digital rectal exam (DRE) and a simple prostate specific antigen (PSA) blood test. The problem is that these two standard tests have been demonstrated repeatedly to provide an unreliable determination of the risk for dying from the disease. Only 20 percent or less of men diagnosed with prostate cancer (CaP) ever die from it, while the remaining 80 percent survive it.
Although this high survivability is considered a positive feature of CaP, because most CaP surgeries lead to side effects like incontinence and erectile dysfunction, a diagnosis of a statistically beatable cancer leads many to either omit the surgery or even the screening tests in the first place. After all, why have a DRE and PSA screening test if the positive results are not reliable, yet will lead the patient to a surgery that is not necessary and likely to cause permanent physical damage?
Some media have reported that PSA testing is not necessary or too faulty to bother with. Although the data these views support is accurate, the conclusions are faulty. It is true, and urologists would agree, that a single PSA or DRE is a poor indicator of CaP risk. However, the utilization of the PSA is very important as part of a comprehensive, aggregate approach to diagnose CaP. As new guidelines state, basic CaP screening with the PSA and DRE is valid, but only when used in conjunction with other prostate cancer risk analyses.
Men have other screening options, and a patient can find a comprehensive aggregate approach. Here are examples that a patient should use to further determine if they have a true CaP risk:
1. The PSA is only relative if it is consistently over 4. If it is over 4, then an explanation is needed.
2. The PSA needs to be consistently rising over years. If the PSA tends to dramatically go up and then down, it is a sign of inflammation, rather than CaP risk.
3. If a patient has CaP in the family, then there is a higher risk probability. If CaP is not found in the family, other problems may be the cause for an elevated PSA.
4. A follow-up is truly necessary if the DRE is suspicious
5. If a prostate biopsy was conducted, was only one core found or many? What is the aggressiveness of the biopsy?
6. There are two preferred methods for imaging a prostate without undergoing an invasive biopsy. The most researched and currently popular is the TRUSP color Doppler. This entails a transrectal ultrasound of the prostate (TRUSP) gland that yields a higher resolution than traditional ultrasound. Utilizing the color Doppler option can determine the amount of blood percolating toward certain high-risk CaP. The more suspect the ultrasound image, the more undesirable it is to see increased blood flow to the area, which suggests higher metabolism and increased CaP risk.
These considerations are only a partial list that illustrate the numerous variables to consider when assessing whether a patient has an aggressive CaP or not, without relying solely on a PSA or DRE test. Any patient discovered with an elevated PSA must be further evaluated. When the conventional physician states that prostate biopsy and/or removal is the “only” option, then alternatives should be pursued.
Consider consulting with a physician trained in both conventional urology and in natural approaches. This allows for a multi-factorial approach (ultrasound and color Doppler imaging, DRE, labs and family history). It is best to seek integrated physicians and analyses to determine where on the continuum of severity one might be before simply following the conventional paradigm of treatment. Prostate imaging is quickly becoming adopted as a way to further determine the presence of CaP and whether such a diagnosis is worthy of removal and its side effects.
Phranq D. Tamburri, NMD, is a naturopathic physician specializing in men's health with a sub-specialty in prostate cancer at Longevity Medical Health Center, in Phoenix. For more information, phone 602-493-2273 or visit LongevityMedical.com.