Good News on the Prostate Front

Prostates and Blood Tests

One of the things men of my age have to contend with is a regular blood test for my prostate. So far, though I’ve stayed at the top end of the range for my age, this isn’t giving my doctor too much concern. And I’ve been on a daily tablet for a couple of years. (When I asked the doctor how long I’d have to take them, she blithely answered, Forever.)

Blood tests for prostate problems are endurable – most people can cope with the quick taking of blood from the arm – but they’re not the most accurate of measurements. This blood test, which is called the Prostate Specific Antigen (PSA), looks for raised levels of a protein in the blood that leaks from the prostate gland. Unfortunately, while it can be a clear indicator of prostate cancer problems, it can also be inconclusive or misleading.

Not for nothing is it known in the medical profession as the Producer of Stress and Anxiety (PSA) test. The thought that you might have cancer when you don’t isn’t helpful to the stress levels of the patient; neither is the thought that you don’t have cancer when you do.

Men Die of Prostate Cancer

Recently I’ve been reading a novel called This Book Will Save Your Life, by A M Homes, and two different characters in it remark that all men die of prostate cancer. This isn’t true, of course, and in fact the percentage of men who do die of prostate cancer is not large. In the UK, for example, while 35,000 men are diagnosed with prostate cancer each year, only 10,000 die of it. hat’s actually a small percentage of the population.

Nevertheless, it’s not an insignificant percentage. And prostate cancer is a vicious way to go. Even those who survive a prostate cancer operation are left in a less than healthy state for months on end. It seems like a small operation, but it debilitates the patient for longer than you’d expect.

The Unpleasantness of Biopsies

Equally unpleasant is the biopsy that’s performed on men to check whether they have prostate cancer or not. The biopsy is necessary because of the inconclusive nature of the blood tests. It involves sticking a sharp object – like a large needle – up through the anus in order to snip, or “punch out”, a piece of the prostate. If you’re a bloke reading this, and you’re feeling ill at the thought of it, that’s not surprising. The process causes acute anxiety in many men, and may even infect them with something that has nothing to do with the prostate.

Worse, though the biopsy shows in 80% of the cases that there is no cancer, it doesn’t actually exclude the presence of cancer.

No wonder the prostate isn’t regarded with great endearment as men get older.

Good News Is On The Horizon

A genetic test has just become available which measures the activity of a gene closely associated with prostate cancer. Doctors hope that it will make diagnosis of the disease more accurate, and here’s the good part, it will reduce the need for most biopsies.

The gene test will help doctors decide whether to go through with a biopsy or not. It measures a genetic chemical called messenger RNA. This messenger transfers instructions from the PCA3 gene, and only produces elevated scores when prostate cancer is present. This makes it much more of a sharply defined diagnosis (if you’ll pardon the pun).

Mostly Good News

Of course there is bad news as well as good. At present a PSA test only costs around £10 in Britain. (It’s free in some other countries.) The new gene test will cost in the region of £200 and isn’t likely to be widely available on the British National Health System for some time. Consequently it may not be the first choice for many doctors, who will stick with the old PSA test in order to reduce costs. And with the biopsies.

Nevertheless, as it becomes more common and more widely available, this new gene test will provide a much safer approach to discerning whether a man has prostate cancer or not, and will bring much needed relief to those many men who prefer not to have a sharp instrument thrust up their rear end.

I’m one of them!