Prostate Specific Antigen

Excerpt

The primary reason for the utilization of any screening exam should be that the procedure detects the early stages of a pathologic condition and allows for early intervention, thereby preventing unnecessary morbidity or mortality before any clinical signs or symptoms of the disease. For the detection of prostate cancer, an elevated serum prostate-specific antigen is the most common initial laboratory abnormality, as the vast majority of men with early prostate cancer have no symptoms.

Prostate-specific antigen, otherwise known as PSA, is a very sensitive but relatively non-specific and imprecise screening tool as both benign and malignant processes will elevate the serum marker. It has also become very controversial, with varying guidelines and recommendations on how it should be used and for which age groups. Despite the risks of serum PSA screening and the potential for some "unnecessary" biopsies as well as overdiagnosis, it remains the single most useful tool available for the early detection of prostate cancer, giving affected individuals the best chance for a cure.

While the use of PSA for prostate cancer screening is somewhat controversial, there is no question regarding its usefulness in helping determine the extent of the malignancy, tracking its progress, identifying biochemical recurrences, and determining treatment response.