Here’s The Reason the Prostate Cancer Awareness Project Exists
The following quote comes from a prostate cancer survivor group I belong to:
“At the age of 51, three years ago, I was diagnosed with metastatic PC, Gleason 3+4, and a PSA of 3.2. I had PSA tests yearly for the 10 previous years and was always in the normal range, with a PSA of 2.0 a year prior. I may be the exception rather than the rule, but I owe my life to the PSA test. I will obviously not live a full life but better here than gone yet. The PSA test is important to survival and if even one man gets a longer life it is worth it. Don’t make the annual PSA screening a “thing of the past”. I have a 25-year old son. Should he suffer the same fate as me?”
Why the Continuing Controversy Over the Value of the PSA Test?
For me, the 11th wonder of the world is the continuing debate within the medical community over the usefulness of the Prostate Specific Antigen (PSA) test as a screening tool for prostate cancer.
Statistical data on prostate cancer deaths clearly show a dramatic drop in the annual prostate cancer death toll following the introduction and use of the PSA test. And that drop was achieved with only 54% of men testing annually.
The comment above mirrors my own experience. This man was diagnosed when his PSA was still within the “accepted norm for men of his age – 4.0,” yet cancer – in fact metastatic cancer, was present. Hum. Maybe those “normal ranges” don’t really apply?
Enter the Free (unbound) PSA Test
So, Just What is “Free PSA?”
PSA (prostate specific antigen) floats in the blood in two forms – attached (or bound) to blood proteins and unattached (or unbound) to blood proteins. The Free PSA test measures the proportion of unattached PSA to the total PSA in the blood sample.Why Does Free PSA Matter?
The percentage of free PSA is lower in men who have prostate cancer than in men who do not.
Do the Doctors Agree?
Once again, there are differing views of the ratio that indicates the presence of prostate cancer. One group uses the level of 25%, meaning a ratio of less than 25% Free PSA, as an indicator of a strong potential for prostate cancer, whereas the National Cancer Institute and the American Cancer Society recommend that men undergo a needle biopsy if the Free PSA remains below 7%.
Do We Have Any Statistics?
In 2002, a study in Finland found that “Prostate cancer probability depended most strongly on the percentage of free PSA. Total PSA, prostate volume, and DRE also contributed to prostate cancer probability, whereas age and family history of prostate cancer did not.” Estimation of prostate cancer risk on the basis of total and free prostate-specific antigen, prostate volume and digital rectal examination. Eur Urol. 2002 Jun:41(6):619-26
Here’s My Personal Experience
I was diagnosed at age 58 with a 3.2 PSA and a negative DRE. In my case, the tumors were located on top of the prostate, so they could not be felt during the physical DRE exam. My 3.2 and negative DRE put in the “normal” “Don’t worry” category.
I was fortunate, however, that my urologist ordered a Free PSA test along with the standard total PSA test. My Free PSA ratio .09 (9%) was far below the target .25 (25%) ratio.
The PSA ratio math is really easy: Just divide your Free PSA by your Total PSA and the result is your Free to Total PSA percentage ratio, which should be .25 (25%) or greater.
If your Free PSA to total PSA is less than .25, you need to see your doctor immediately and explore the potential causes.
My Doctor Tells Me I’m Too Young for a PSA Test. What Now?
Boy, now we’re on sensitive ground. This is one of the most common responses I heard during my 48 day motorcycle ride across the US and back last summer for prostate cancer awareness. (tourdeusa 2010).
Important: When reading my material, please note that I am not a doctor and I never give medical advice. I can only relate my personal story (and the stories of others) and my views based on almost eight years as a prostate cancer survivor.
You can go to a local laboratory and order these tests yourself. You can also go online to Life Extension Foundation and order these tests. They will send you to the same lab your doctor uses and the results will come directly to you. Even easier, you can go to Blood Tests at Home and they will send a test kit to you by mail and return the test results to you within 10 days. Total cost for Blood Test at Home is $26.95, including postage.
How to Have Early Warning Prostate Cancer Warning With No DRE!
Many guys just can’t seem to “man up” enough to handle the digital rectal exam (DRE) that is part of the annual prostate cancer exam. You guys should have been in the Army with me. For four years of my career I flew helicopters, which meant an annual flight physical that included, you guessed it, a DRE, and it seemed like every flight surgeon played linebacker in college.
If I can manage it, so can you!
But, from the article, you should see that a combination PSA and Free PSA test actually may be more effective that a PSA and DRE. It took that Free PSA test to save my life.
Warm regards, Robert