PSA Test for Prostate Cancer Definitely Flunks

Making the Grade...

If I were grading the PSA test for prostate cancer, I would say it definitely flunks. And I'm not the only one: A study published in the Archives of Internal Medicine maintains that the routine screening test for prostate cancer may not reduce a man's risk of dying from the disease.

The study, conducted by the Veterans Affairs Connecticut Healthcare System and Yale University, identified 501 men ages 50 and older who were diagnosed with prostate cancer between 1991 and 1995 and who had died by the end of 1999. A comparison was made between these men, who were treated at any of 10 Veterans Affairs medical centers in New England, and 501 living men, who were matched for age and treatment at the same VA center.

The medical records of both groups were reviewed to determine whether the men had been screened for prostate cancer. The researchers found that 14 percent of the men who died of the disease and 13 percent of the control group were screened using the prostate-specific antigen or PSA blood test. It was determined that the screening was not an effective tool for preventing prostate cancer deaths, given that virtually the same amount of men died whether they were screened or not.

In addition, investigators noted that screening men who were younger or healthier, or conducting digital rectal exams, also did not appear to reduce mortality.

The study reopens questions about the downside of this type of cancer screening, such as the number of false positives generated by the test, the risk of infection because of biopsies performed based on the test, and the aggressive treatments that usually follow diagnosis which can cause incontinence and sexual dysfunction.

Dr. Wright has covered two different types of prostate cancer screening tests in Nutrition & Healing -- ones that will sound familiar to most of his female readers: the estrogen quotient (EQ) and the 2/16 ratio test. These tests predict estrogen-related cancers like ovarian, breast, etc. You might be wondering why a test that predicts estrogen-related cancer risk also works for evaluating prostate cancer risk. Well, male bodies also contain estrogen. In fact, the male body actually turns testosterone into estrogen by a process called aromatization.

If everything is functioning properly, only a small fraction of your total testosterone becomes estrogen. Unfortunately, as men get older, there's a tendency for this process to speed up, turning more and more testosterone into estrogen. If this happens your body makes more estrogen than is good for your prostate and leaves too little testosterone behind. This raises the risk of both prostate enlargement and prostate cancer. But both the EQ and the 2/16 ratio tests can help you and your doctor determine if you have too much estrogen in your system. Even better, these tests are completely non-invasive: They involve collecting urine specimens in the privacy of your own home and then sending them into a lab to be tested.

To read more about these tests, refer back to the July 2003 issue of Nutrition & Healing. Subscribers can download it for free by visiting www.wrightnewsletter.com and signing on with the username and password listed on page 8 of your most recent issue. And if you're not already a subscriber the website also has details on becoming one.

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What is...prostate-specific antigen?

Prostate-specific antigen (PSA) is a naturally produced protein of the prostate gland that is found in the blood. PSA testing works by measuring the blood-levels of this protein. While prostate tumors cause an over-production of PSA, the test can generate false positives because PSA levels can also be raised for reasons other than prostate cancer, such as an infection or benign enlargement of the gland.

Yours in good health,
Amanda Ross
Editorial Director
Nutrition & Healing