Prostate news article, October 2004
| THE PSA TEST
IS NOT USELESS, AFTER ALL!
Professor Roger S Kirby St George's Hospital, London |
 |
In the October issue of the Journal of Urology Dr Thomas Stamey and his group from Stanford University, California publish a report that has been widely quoted in the press as confirming that "the PSA test is useless".
In fact, that headline is a misleading over-simplification. What the Stanford researchers have found is that the original close relationship between the volume of cancer in the prostate and the PSA value at the time of diagnosis has been lost in recent years. As prostate cancers are now detected much earlier than between 1983-1988 (before PSA testing was widely available), this is in fact not surprising. Prostate cancer is very often multifocal within the gland, making volume measurements difficult. Moreover the PSA only starts to rise steeply once invasion of the capsule occurs or when distant metastases develop, which was more often the case in the 1980's.
The PSA test, although imperfect, remains our best means of detecting prostate cancer at a stage when it can still be cured. It is also invaluable as a marker of response to treatment by surgery, radiotherapy or hormone therapy. The debate will run and run but the current consensus is that the PSA test is still of value. However, more research is needed to develop more accurate markers that also provide information about how individual tumours will behave over time.
Reference: Stamey et al J Urol 2004 172:1297-1301