PSA: Controversy or Control Measure?   The PSA has been put to the “test” literally as of late.  What many fail to report when writing reams on why the PSA is not an accurate indicator of prostate cancer is this:  It is and for quite some time has been.  Perhaps many do not think the 40-60% accuracy grading is sufficient enough for make men to sit up and take notice.  Well, considering Prostate Cancer is typically slow-growing; that the test can be repeated with 4-6 weeks if a test is suspected to be false-positive; and that compared to what women have for detecting breast cancer the PSA is quite a great tool! 

Is it true that a high PSA level can be indicative of enlarged prostate (BPH), infection – commonly both experienced as men age? Yes.  Can it be elevated as much as two days after physical activity – from riding a motorcycle to having intimate relations? Yes.  Not everyone is going to agree on whether this is a test for everyone to have but statistically it has saved more lives than not.  More than enough reason not to dismiss it too lightly.

So What to Do??? Your Homework.  If you have familial history of prostate cancer, are of Afro-American descent, over the age of 40-45 – the PSA in my estimation should be a definite test to have done yearly. 

Don’t Like the PSA Reading? Well you have OPTIONS.  You can tell your doctor you want to REPEAT the test in another 4-6 weeks before undergoing a biopsy for a better chance there was not a false-positive reading.  You can ensure a Free Floating PSA is done (Free PSA) that measures the PSA free floating in the bloodstream and compares it to the PSA in the prostate area.  Devised by Johns Hopkins some time back, the wonderful tool helps eliminate unwanted biopsies in many, many men. 

Some FREE PSA Facts Every Man should Know: For several years, physicians and scientists have attempted to make the PSA test even more accurate/useful.  Most attempts – PSA density, velocity, age dependent PSA ranges were impossible to verify and not always useful.  The Free PSA, however is reproducible and useful. Again the Free PSA is that percentage of the total PSA that circulates in the bloodstream without a carrier protein.

In the graph below, the horizontal access is the percentage of Free PSA. The lighter line (CaP) corresponds to cancer patients and has a sharp peak at 10%. The darker line corresponds to the distribution of Free PSA in patients whose biopsies did not show prostate cancer. AUC means area under the curve. The relative size of the area under the curves for prostate cancer and benign prostate enlargement correspond to the chances of finding prostate cancer.


In other words, Free PSA may eventually allow us to forgo biopsies altogether in men with PSA’s between 4.0 and 10.0 and a Free PSA of more then 24%.   That, in itself, makes the Free PSA test an outstanding tool!

Quick Way to Determine Yours: Take your  Free PSA, divide by the total PSA and multiply it by 100.
0.8(Free PSA) Divided By 2.8 (Total PSA) x 100 =% of Free PSA (28.6%)
(Note: This is obviously good as a Free PSA of 25% or higher is desirable)


IMPORTANT INROAD FOR A MORE ACCURATE PSA TEST FROM JOHNS HOPKINS UNIV.(Baltimore):   An experimental blood test that may more accurate detect prostate cancer that it could replace the current method and produce a completely accurate mechanism for detecting prostate disease.   Researchers at Johns Hopkins discovered an early prostate cancer antigen known as EPCA-2 which functions as a biomarker. In sampling 330 men, EPCA-2 levels were able to identify 94% of those with prostate cancer and 97% who were cancer-free.  It was noted that it was also capable of differentiating which cancers were prostate-gland confined to those that had metastasized.  Subjects used were from all areas: those with normal PSA levels with no evident disease; normal PSA levels with cancer, elevated PSA levels with negative biopsies as well as BPH (benign prostatic hyperplasia/enlarged prostate) without prostate cancer.

The EPCA-2 test was able to identify 78% of men as having prostate cancer with PSA levels below 2.5 – which is quite amazing to myself, as someone that has watched detection tools over the years, as well as 3/4 of BPH patients with a EPCA-2 level below the cutoff point of 30 ng/ml. 

Robert Getzenberg, Ph.D. and Dir of Research at James Buchanan Brady Urological Institute at Johns Hopkins, was quoted as saying this result was significant because BPH is often associated with elevated PSA levels, leading to misdiagnosis.

I find this particularly wonderful information to pass along to men!    I see this EPCA-2 blood test as a tool to vastly improve the accurate detection of prostate cancer EARLY and MINIMIZING the false-positive numbers…thereby the need for men to undergo unnecessary biopsies.  That in itself is beyond encouraging.

Researchers also found EPCA-2 levels were highest in men whose cancers had spread beyond the prostate area, making it far easier to detect advanced disease than PSA tests alone allow for. “This fact alone is important, since cancer that has spread outside the prostate is more deadly, which makes it even more crucial to have a tool that detects it early.” Dr. Getzenberg said.   He is planning  a larger clinical trial and estimates that the test could be approved for general use in about 18 months. Funded by the National Cancer Institute of the National Institutes of Health and Onconome, Inc., a biotechynology company in  Seattle.

Pulse Nutritional’s hat is off to Dr. Getzenberg and all those working on perfecting this test and bringing it into utilization as quickly as possible. There may be no perfect PSA test thus far…and we still stand behind the current testing methods….and eagerly await to hear more about the day a test such as EPCA-2 becomes the standard.