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PSA Testing Still Valuable for Prostate Cancer
Date:10/7/2007

t 15 years. While one in six men will get prostate cancer during his lifetime, only one in 34 will die of the disease.

"We're seeing people living 15 to 20 years with their prostate cancer, which we didn't see in the '80s and '90s," said Dr. Susan Slovin, chairwoman of the National Prostate Cancer Coalition's scientific advisory board.

But the key is early detection.

Ninety percent of all prostate cancers are found still within the prostate gland, or only in nearby areas, according to the American Cancer Society. For those patients, the five-year survival rate is nearly 100 percent. But for the men whose cancer has spread to distant parts of the body when it is diagnosed, the five-year survival rate falls to 34 percent.

The cancer society recommends annual screenings for prostate cancer beginning at age 50 for most men, and at age 45 for men at high risk. Those at high risk include blacks and men who've had a close relative suffer from prostate cancer before age 65.

The screening involves two steps: undergoing a digital rectal exam and testing for PSA levels in the blood.

In the rectal exam, the doctor feels the prostate to see if there are any bumps or hard spots that might signify cancer.

And although PSA is not an indicator of cancer, but a protein created during inflammation of the prostate, doctors have found that highly elevated levels indicate an increased risk for cancer.

Studies now show that the regular testing of PSA levels can indicate cancer risk by showing rises or falls in the protein's levels.

"They've been trying to see if you can use PSA as a predictor by looking at a trend," Soules said. "It's met with some good success."

PSA trends -- or PSA "velocity," as doctors refer to it -- also can help guide treatment for prostate cancer, said Slovin, an assistant member of the Genitourinary Oncology Service at Memorial Sloan-Kettering Cancer Center, and an
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