Understanding the
spike
The
Fred Hutchinson Cancer Research Center in Seattle, in the US, recently
released a
report on a study that set out to understand why there was an
unusual surge of
prostate cancer that peaked in the early 90's and then went
back down.
Many
researchers and doctors suspect the spike in these numbers may have been
due to
over-diagnosis, probably caused by the uncertainties of prostate
specific antigen (PSA)
screening.
The
Seattle team developed a computerised projection of what the increase of
prostate
cancer might have been without prostate specific antigen (PSA)
screening. Their
computer model tracked a hypothetical group of two million
men, aged 60 to
84. The
researchers then matched their projected incidence of diagnosis with
data from
the National Cancer Institute's Surveillance, Epidemiology, and End
Results
(SEER) programme that tracks cancer incidence and survival data around
the US. The
projected rates of prostate cancer over-diagnosis were found to be
consistent
with the SEER data.
Their
conclusion: using PSA screening, between 29 and 44 percent of the
patients were
estimated to be over-diagnosed. (The percentage varied by race.
Black men suffer
higher incidence of prostate cancer, though researchers have
yet to discover
why.) Risks
in the balance The
common denominator for all of these men, of course, is PSA screening.
Elevated
PSA levels provide a primary clue that something might be wrong with
the
prostate gland. But reading the results of PSA data is still an inexact
science,
partly because elevated PSA levels alone don't indicate the presence
of cancer.
This
is where the doctor encounters a troubling dilemma. If the PSA levels
are high
and other tests indicate that there are reasons to suspect cancer, no
physician
wants to risk missing the diagnosis. But all too often - as the
Seattle test
confirmed - the indicators will point to cancer, then the biopsy
will come back
negative. And
that would be fine if biopsy of the prostate were a risk-free procedure.
Unfortunately the opposite is true. Common biopsy side-effects include
bleeding
and infection. Moreover, surgical prostate cancer treatment can cause
nerve
damage that results in impotency and loss of bladder control.
A
critical distinction: two forms of PSA Part
of the over-diagnosis problem may stem from a misreading of the PSA
levels.
According to Dr. Charles Myers, editor of The Prostate Forum (as well
as a PC
survivor), there are two forms of PSA: prostate specific antigen
that's bound to
other proteins in the blood, and "free" PSA. The percentage of
free PSA typically
declines as cancer develops.
Dr.
Myers cites an important urologic surgery study that shows how men with
a free PSA
level of 25% or less may constitute a very high percentage of all
prostate cancer
victims. If this distinction between bound and free PSA is
misunderstood or
misread, it can make all the difference between an accurate
and an inaccurate
diagnosis.
With this
important factor in the balance, the decision to proceed with a
biopsy or surgical
treatment should not be taken lightly. So this can't be
stressed too
strongly: men, if you are diagnosed with prostate cancer, be
diligent in asking
questions and don't be afraid to seek a second opinion. As
the report of this
study itself advises: "The important possibility of
over-diagnosis
should not be underestimated or overlooked."
Good
prostate health Prostate
cancer is the second most common cause of cancer death in men.
Needless to say,
every man should be taking steps to good prostate health long
before his first
PSA screening.
A
new study shows that
vitamin E
(Solal Technologies
has the most superior form of Vitamin E available. Commercially
available Vitamin E do not provide the full benefits as they do not
contain the full spectrum of Vitamin E)
can help keep prostate
cancer cells from
developing and
spreading. Vitamin E is particularly effective in fighting
prostate cancer
when used with other natural treatments such as selenium and
vitamin D.
Saw
palmetto supplements have been shown to benefit prostate health without
increasing
testosterone levels. In fact, saw palmetto is even touted by the
American Medical
Association and researchers at Harvard as showing great
promise in the
fight against prostate cancer, despite their more common stance
against
natural medicine.
Pure
beta-sitosterol
is better than Saw Palmetto -because it is
the concentrated active ingredient. Full article available from
Solal Technologies. Other
prostate cancer fighters include milk thistle, and the spice
curcumin (only available from
Solal Technologies)
(known as turmeric). All of
these (including saw palmetto) are available at
most good
health-food stores. And they're all relatively inexpensive
supplements that
can pack a powerful punch against prostate cancer.
But
one important word of caution: supplements used to increase testosterone
levels may
be harmful, as higher hormone levels have been associated with
prostate cancer
growth. Sources:
"Overdiagnosis
Due to Prostate-Specific Antigen Screening: Lessons From U.S.
Prostate Cancer
Incidence Trends" Journal of the National Cancer Institute,
Vol. 94, No. 13,
981-990, July 3, 2002
"Prostate Cancer
Incidence Trends Reveal Extent of Screening-related
Overdiagnosis"
Press Release, JNCI
"Cancer Facts"
National Cancer Institute
"Prostate Forum /
Solving the Puzzle / Prostate Cancer Screening" Dr. Charles
E. Myers, Jr., MD
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