Johns Hopkins Health Alert
More Prostate Cancer: Fact or Fiction
This excerpt from a recent Johns Hopkins Prostate Bulletin looks at four common misunderstandings about prostate cancer.
Myth: A PSA of 4 ng/ml or less is normal and means that no prostate cancer is present.
Fact: There is no such thing as a "normal" PSA result. It's estimated that 15 to 20 percent of men with a total PSA of 4 ng/ml or less actually have clinically significant prostate cancer. What a smart clinician will do is look at any changes in PSA velocity -- the rate of rise in PSA from year to year -- and use this critical figure to inform the patient about possible next steps.
Myth: An elevated PSA test indicates that prostate cancer is present.
Fact: Not necessarily. PSA levels increase when excess prostate specific antigen enters the bloodstream due to a prostate disorder. This could be a prostate infection from a urinary tract infection or prostatitis, or benign prostatic hyperplasia, an enlargement of the prostate that often occurs with age.
What the PSA test does better than any other assay we currently have is inform the doctor that some type of activity is occurring in the prostate. Before ordering a prostate biopsy to look for cancer, a savvy urologist will first rule out other prostate disorders and prescribe medication, if necessary, to treat a suspected medical issue. Following a repeat PSA test several weeks later, if PSA remains elevated, or has risen further, a biopsy will then be performed to check for possible cancer.
Myth: The prostate biopsy exam will cause cancer to spread if present.
Fact: A prostate biopsy is ordered when a urologist suspects -- based on the DRE and PSA test -- that prostate cancer may be present. There is no evidence that piercing the prostate with the biopsy needles during the procedure will cause prostate cancer to spread.
Myth: A prostate biopsy exam will lead to erectile dysfunction.
Fact: After the gland is punctured a dozen times during the course of a prostate biopsy, there will be some swelling and inflammation. However, this swelling has no impact on erections. There will often be blood in the urine and semen for several weeks following biopsy, but this, too, has no effect on the ability to attain and maintain an erection.
Posted in Prostate Disorders on August 18, 2011
Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer
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To advise that there is no evidence that piercing of the prostate with a biopsy needle does not cause spreading of the cancer may very well be true. However this only advises that there is no evidence. To my mind the prostate does not operate under a negative pressure and piercing of the outer wall will surely lead to leakage and the subsequent escape of cancer cells.
Posted by: sylken2443 | August 18, 2011 6:16 PM