Some of the current controversy surrounding the PSA Test stems from the recommended treatments after finding an elevated PSA level. Many Physicians err on the side of caution, so they may order a biopsy on the Prostate, which is not always necessary. A PSA test is a valuable tool but should probably not be relied on exclusively. A Digital rectal exam should be performed annually which allows for masses to be found. A mass can be present on the prostate with a normal PSA level. If a digital rectal exam reveals a mass or enlargement of the prostate gland, an ultrasound of the prostate could be ordered to visualize the gland. At this time, a biopsy may be recommended to determine your “Gleason score.”
Is all of this necessary?
My answer is you should always have the right to make an informed decision and to arm yourself with as much information as possible. While I would not rely on the PSA test as a solitary means for prostate cancer screening, I do recommend it as an assessment of overall prostate health. A patient’s care should be customized to fit their needs. For example a man with family history of prostate cancer will need earlier PSA tasting than a man without such history. No authority should be able to tell you what test you can or cannot have your Doctor order for you. Men with changes in their PSA levels should know about them and be able to make informed decisions as to what the next step should be.