Whilst breast cancer screening clearly saves lives, the case for prostate cancer is not so clear. This is partly because at present there is no test that is accurate enough to be reliable.

The test that is available is known as the PSA test.  This is a blood test that measures the level of a substance known as Prostate Specific Antigen (PSA).

Increased levels of PSA in the blood is taken as a strong signal that a prostate cancer is present.  This test is not, however, totally accurate. Whilst it can give a strong indication that prostate cancer might be present it is not always the case. PSA can also be elevated due to less serious aliments such as infection or an enlarged prostate.

It is also unclear whether the PSA test can reliably detect whether a man with prostate cancer will benefit as a result of treatment. This is of particular significance because, due to the location of the organ, the treatments for prostate cancer can have serious side effects such as incontinence and impotence.

A proportion of prostate cancers grow very slowly and may not cause clinical problems or be life threatening   in these cases treatment may not be needed.  So, whilst these men may test positive on the PSA test, they will not go on to develop the life-threatening form of the disease. Indeed, many men with prostate cancer do not know it!  In these cases screening may do more pyschological harm than potential physical good.

The Government has recently launched a Prostate Cancer Risk Management programme which aims to ensure that men who are concerned receive information about the advantages / disadvantages of a PSA test and possible treatments for prostate cancer. The PSA informed choice Project means than men over the age of 50 can request a PSA test after they have received appropriate counselling.

Current research is looking into the development of a laboratory test that will be able to distinguish whether a particular prostate cancer is of the aggressive life-threatening form or not.

02/06/2009