Take Charge of Your Prostate Cancer Screening Decisions to Minimize Regrets – Late Diagnosis or Premature Biopsy
Are you a passive patient? Or are you eager to take charge of your prostate cancer screening decisions to minimize regrets?
Your primary care physician may advise against prostate cancer screening using the PSA blood test – to avoid premature biopsy, over-diagnosis and side effects. Your urologist may advise PSA testing - to avoid late diagnosis and minimize prostate cancer death risk. Neither may have time for a deep conversation about the implications or about a smart screening process that will require your active leadership.
Most physicians do not have time to use prostate cancer risk calculators for best risk assessment, which puts you at risk of a premature biopsy.
For most men, the most effective prostate cancer risk assessment uses the ERSPC Risk Calculator along with ultrasound imaging for prostate volume and cancer risk and the Prostate Health Index (PHI), as I discussed in my previous Blog post on prostate cancer risk calculator and premature biopsy.
Incomplete risk assessment can lead to either a premature biopsy or regrettably late diagnosis of deadly cancer. Although effective risk assessment reduces both risks, I will focus on premature biopsy, which seems far more prevalent for men screened with PSA.
A collaborative team effort is often necessary to achieve the most effective risk assessment with analysis done by you, or by you with our help, or by us with our Prostate Smart services.
Prostate cancer risk calculators can help you avoid premature biopsy, treatment & side effects.
A premature biopsy occurs before you are ready based on your risk tradeoffs when they are informed by full use of new screening technology and effective prostate cancer risk calculators.
Triggered by elevated PSA, premature biopsy, possible diagnosis and treatment can lead to:
Your "Underlying" Free PSA, Prostate Health Index (PHI), 4Kscore may differ from reported.
It is critical to estimate your "Underlying" PSA, Free PSA %, Prostate Health Index (PHI) and 4Kscore, which may differ from your most recent reported values because of temporary infection, inflammation or aggravation of your prostate. Infections of your prostate or urinary tract are most problematic because they affect both PSA and Free PSA in ways similar to prostate cancer, and both PSA and Free PSA are key components of Free PSA%, Prostate Health Index (PHI) and 4Kscore.
Your "Underlying" PSA may be substantially lower than your reported PSA.
It is critical to estimate your "Underlying" "True" PSA test level, which may be lower than your most recent "True" value because of temporary infection, inflammation or aggravation of your prostate.
Your "True" PSA may be substantially higher than your reported PSA.
It is critical to use your "True" PSA test level which may be substantially higher than your reported PSA value because of WHO PSA test calibration and/or treatment for prostate enlargement (BPH).
Tom Neville, PhD, is a prostate cancer survivor with a mission to help men make better decisions. He is a Rhodes Scholar from Yale, Phi Beta Kappa, with a Stanford PhD who has worked with leading prostate cancer researchers.