Interpreting PSA Test Results
Robotic prostate surgeon, David Samadi, MD, defends the use of PSA blood tests as 'a vital first step in identifying the potential presence of prostate cancer.
This spring, the U.S. Preventative Services Task Force (USPSTF) gave men a free pass on their annual prostate-specific antigen (PSA) blood test. Many prostate cancer experts, including robotic prostatectomy surgeon, Dr. David Samadi, worry that pass could cost some men their lives. In the November Health Radar newsletter published by NewsmaxHealth, Dr. Samadi called the USPSTF recommendations “irresponsible” and detailed his conservative and thorough approach to analyzing PSA test results. If more widely applied, such protocol might yield better government support for the test that many call a life-saver.
An innovator in the field of robotic prostate surgery, Dr. Samadi performs his own Samadi Modified Advanced Robotic Technique (SMART) at New York's Mount Sinai Medical Center where he serves as Vice Chairman, Department of Urology and Chief of Robotics and Minimally Invasive Surgery. He is a firm believer in routine PSA screening and credits a portion of his prostate cancer surgery success to the life-saving opportunity afforded by early diagnosis.
However, Dr. Samadi is careful to explain the use of the PSA level in diagnosing the disease. “The PSA test is not a prostate cancer test,” he says. “But it is a vital first step in identifying the potential presence of prostate cancer.” He encourages men to seek the counsel of a physician with proven expertise in prostate cancer and PSA test analysis. Doing so, he says, can help avoid “knee-jerk reactions” and cookie-cutter treatments.
To the readers of Health Radar, he offered these considerations for interpreting a higher-than-normal PSA:
• Prostate cancer is not the only cause of an elevated PSA
• PSA level can increase with prostatitis, BPH (benign prostatic hyperplasia), or even recent sexual activity
• Antibiotics can be used to address an elevated PSA when no physical irregularity is noticed during physical exam
• Prostate biopsy should be performed only when a prostate nodule is present, the PSA level is non-responsive to antibiotics, and/or repeatedly high PSA test results are obtained
In the article, Dr. Samadi referenced past patients who chose PSA testing only as a requirement of their life insurance application. “That test saved their lives,” he said. While Dr. Samadi is highly concerned about the broad implications of the USPSTF's recommendation against routine screening, he continues to stress appropriate application and interpretation.
Highly specialized oncologic urologists who spend their days analyzing PSA results and treating prostate cancer, are only a consult away. Men of all ages are encouraged to see the opinions of these experts for the most effective and targeted prostate cancer analysis.
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