Prostate cancer screening (PSA)
Should I have a PSA?
Scientifically this is a difficult question to ask when considering a population of men. But when its personal its perhaps a bit easier as you can apply your own values to issues which healthcare systems find difficult to apply to everyone.
PSA is a product of the prostate which forms a constituent of the semen. It leaks into the blood a little and the amount of this ‘leak’ can rise with various prostate conditions including enlargement, infection, inflammation and of course cancer.
The first question you may ask is, can PSA testing help find prostate cancer early? The answer to this is very clearly yes. Men with an elevated PSA are more likely than those with a low PSA. So having a PSA test can identify if you are at increased risk.
The best research available suggests that the risk of death from prostate cancer can be reduced by PSA screening of asymptomatic menbut at the risk of identifying cancers that may not harm you and the subsequent over-treatment of these cancers.
Men with urinary symptoms should always have a PSA test and the benefits certainly outweigh the risks in these men.
Book at consultation with Mr Dudderidge to discuss the issues further and help you to decide if you would like a PSA test.
Investigation of a high PSA test
Men with a high PSA test need a full urological assessment. This includes assessment of urinary symptoms and bladder emptying and a calculation of the your individual risk using the prostate cancer risk calculator.
For those considered at increased risk a trans-rectal ultrasound guided prostate biopsy used to be the next step. However Mr Dudderidge has been advocating multi-parametric MRI as a primary test prior to biopsy for some years and the latest evidence suggests 25% of men may safely avoid a biopsy using this scan.
In many centres men are only offered systematic random biopsies throughout the prostate. However Mr Dudderidge uses findings from the MRI scan to direct targeted biopsies into suspicious lesions in the prostate. Using state of the art software Mr Dudderidge is also able to perform MRI-Ultrasound image fusion to get even more accurate targeting of lesions. Typically Mr Dudderidge suggests transperienal biopsy for many men to help avoid the infection risks of trans-rectal biopsy.
Using risk assessment, imaging and targeted biopsy Mr Dudderidge has seen significant improvements in the accuracy of the diagnostic process compared to traditional methods.