January, 2005:
Back in 1987, Stamey was among the first to suggest that the level of PSA, a protein normally produced by the prostate gland, might be useful in detecting prostate cancer. But based on an analysis of more than 1,300 prostates removed over the past 20 years, Stamey reported in the October issue of the Journal of Urology that the PSA test is currently predictive of cancer in only 2 percent of cases. Because of the increase in screening and detection of prostate cancer over the past two decades, he now says a higher PSA level may most often reflect a harmless age-related increase in prostate size.
When doctors follow up a high PSA level with a biopsy, they often find cancer. But this is only because most men have some degree of prostate cancer. Studies have shown that 80 percent or more of men over age 70 die with—but not from—prostate cancer. As counterintuitive as it seems, detecting prostate cancer is not always in the patient’s best interest. Once cancer is diagnosed, most men opt for treating it either with radiation or removal of the prostate. In many cases, that leads to impotence, urinary incontinence, and other unpleasant side effects.
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