David Bryan, M.D. 's Urology Blog

September is National Prostate Health Month, drawing attention to a question I get every day: Should I get a PSA test, doc?

The primary screening tool used to detect prostate cancer is a blood test that detects prostate-specific antigen (PSA) – a protein that is produced by the prostate gland. There is obviously great value in knowing your PSA number, as the higher a patient’s PSA level, the more likely he is to have prostate cancer.

I cannot definitively tell you whether or not you should undergo PSA testing – that’s a personal decision to be made by the patient, and the patient alone. As a urologist, however, I can help men put their personal histories in context with medical understanding and expertise. Ultimately, to be an informed patient, you must be informed about your health. Put simply, Your Numbers Matter.

Learning your PSA number is the most common procedure to screen men for prostate cancer, and without prostate cancer screening, you can’t detect prostate cancer. If you can’t detect prostate cancer, you can’t treat prostate cancer.

Many of my patients are aware that the majority of prostate cancers grow slowly. A commonly repeated phrase in the media is that “men are more likely to die with prostate cancer than to die of it.” And while that may be true, it’s critical that patients and health care providers alike do not diminish the risks associated with the disease. After all, cancer is cancer, and prostate cancer – specifically – is the most common cancer among men in the United States, claiming upwards of 20,000 lives annually.

Thankfully, prostate cancer can often be found early, when it is most likely to be cured. The trick is to weed through your own medical and family history with your urologist. But, for many men, even getting to the doctor’s office poses a challenge.

I often encounter patients who have the “if it ain’t broke, don’t fix it mentality,” keeping them from making preemptive appointments, or taking the initiative to become more well-informed about their health.

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This September is as good a time as any to take charge of your health. Rather than delaying your checkup for yet another year, man up. Check in with your urologist to learn your PSA number. Knowing your numbers will help you make smart lifestyle and health care choices while allowing your physician to more easily treat and prevent common, but often overlooked, urological conditions, such as prostate cancer.

Prostate Cancer Screening Still Not Recommended for All – NYTimes.com.

Testosterone Therapy Debated at American Urological Association Meeting.

Come out and support a great cause!  SLUS is hosting the first annual ZERO Prostate Cancer Run/Walk.  We are also selling Tickets to a St. Louis Cardinal’s Game on August 14th vs. San Diego Padres.  Tickets are discounted to $25 each.  come out and join the cause!

2014 ZERO Prostate Cancer Run/Walk – St. Louis – Home.

Here’s a useful free app to understand Overactive bladder.  Check it out!

Home Page.

Check this out, very handy!

PSA Manager on the App Store on iTunes.

Could Heavy Coffee Drinking Help Men Battle Prostate Cancer?.

I knew it!

Fish oils may raise prostate cancer risks, study confirms – NBC News.com.

The American Urological Association and the Urology Care foundation just came out with this brochure to help patients decided about PSA testing.

The American Urological Association (AUA) has issued new guidelines for prostate cancer screenings. The guidelines were developed from a systematic literature review to ensure that men most likely to benefit from detection are screened and to encourage shared decision-making between the patient and physician.

The new guidelines state:

• Men 55– 69 years of age who are considering PSA screening should now speak with their physician about the benefits and harms of testing to determine the best course of action.
• PSA screening is not recommended for men <40 years of age, men at average risk between the ages of 40–54 or those >70 years old or with less than 10–15 years life expectancy.
• Men outside the age range of 55– 69 years who are at higher risk of prostate cancer (race, family history, etc.) should still speak to their physician about the benefits and harms of testing.
• To reduce the harms of screening, a routine screening interval of two years or more may be preferred over annual screening in those men who have participated in shared decision-making and decided on screening.

In 2009, the AUA best practices statement had recommended that men >40 years old (in good health with more than 10–15 years of life expectancy), and men at high risk speak to their physician about prostate-specific antigen (PSA) screening. Unlike the new guidelines, these recommendations were based more on consensus opinion rather than systematic literature review. 

PSA screening has played a part in decreasing prostate cancer mortality, but screening without clearly targeting those who are most likely to benefit can result in over diagnosis and treatment, potentially causing more harm than good.