Biff makes good prostate point; here’s even more information |

Biff makes good prostate point; here’s even more information

Biff America’s column on the prostate gland had good advice. Men older than 40 need to start developing an information base in order to detect prostate cancer.

The digital rectal exam, which had been used most commonly before the PSA blood test was introduced, is not particularly sensitive to early symptoms of prostate cancer. By the time a physician can actually detect any abnormalities using this type of exam, there is usually a substantial tumor, one which may have already spread outside of the capsule that encases the prostate. A PSA value is a much better early warning detector. Which brings me to another point.

Regular PSAs give you a baseline that allows you to detect the early warning signs of cancer.

While Biff is correct that a general rule of thumb is a value of 4.0, higher values (e.g. 5.0) are not necessarily problematic for men older than 50. PSA will go up gradually as men age. This is OK. It is simply indicative of the aging of the gland. But a PSA value of 3.0 could be a serious problem for a 43-year-old whose value was 1.5 the year before. It is the increase in PSA, regardless of base level, that is most useful for diagnosis.

Incidentally, Biff, in the prostate, size does count. Generally speaking, the larger the prostate, the higher the PSA. So, in this case, smaller is better. Not that there’s anything wrong with that. But even though you may win your “contest,” if your PSA doubles in a year, you need to pay attention to that increase.

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