Prostate Specific Antigen

Sir Chris Hoy, who is six-time Olympic cycling champion stunned the British public recently by revealing that that he has stage 4 incurable prostate cancer.

It was even more shocking because of his young age. He is only 48 years old !

Naturally, many men under 50 yrs would be concerned.

According to CRUK statistics “1 in 6 men in UK will be diagnosed with prostate cancer”.

But majority of cancers occur in men 60 yrs and above. The peak age for prostate cancer is in the 75-79 age range. Prostate cancer is very uncommon before age of 50.

So in most men, screening for prostate cancer is not recommended before the age of 50.

There are some exceptions to this age limit of 50. For example, men with black ethnicity or those with a family history of prostate cancer are at a higher risk. These men can consider requesting a PSA test in their mid 40s.

Please note prostate cancer screening does NOT result in better lives for everyone. Screening has its benefits but it also has drawbacks .

A cancer diagnosis is terrifying but it is important to note that NOT Everyman with prostate cancer will die due to prostate cancer. Lot of men with early prostate cancer will die of something else. Moreover, treatment for early prostate cancer has significant side effects.

That is why every man is NOT routinely and automatically offered screening by their GP surgery in UK.

Even though routine PSA testing is not offered on the NHS, as mentioned in the NHS website “Men aged 50 or over can ask their GP for a PSA test, even if they do not have symptoms”.

References

1. BBC news. Prostate cancer symptoms and treatment: What to check for.

2. BBC news. NHS to review prostate cancer testing after Chris Hoy call for change

3. NEJM. Fifteen-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Prostate cancer is the most common male cancer and is one of the most common cause of death due to cancer.

Yet, paradoxically most men with prostate cancer die “with it” rather than “of it”.

It does take a bit of thinking to get the head around the above two facts.

At present, we use a blood test called PSA ( prostate specific antigen) to detect prostate cancer. It is the most widely used and best available blood test. But it is not perfect.

PSA detects too many “mild cancers” which do not need to be detected because those “mild prostate cancers” do not affect the life expectancy in most men.

PSA can also sometimes miss “severe cancers”.

Hence the search is on to find better tests.

A U.K. led team has now developed a “saliva” (spit) test to improve the detection of prostate cancer.

The promising results presented at ASCO 2024 meeting in Chicago hopefully will be followed by more confirmatory trials before it becomes standard practice.