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Learn Your Prostate Cancer Fate Before 50

Mount Sinai robotic prostate surgeon, David Samadi, MD, shares new findings that PSA testing before age 50 could predict nearly half of all deadly prostate cancers

NEW YORK, NY – New research from Sweden appears to provide further support for the benefits of early prostate cancer screening tool, the prostate specific antigen (PSA) blood test. After a 30-year follow-up with one quarter of an original 20,000 participants, researchers concluded that the PSA baselines of men before age 50 could have been used to accurately predict long-term prostate cancer metastasis in 44 percent of participants.

Long-term studies such as this, published in the April 16, 2013 issue of The BMJ, http://www.bmj.com/content/346/bmj.f2023, help clarify the role of PSA test results in prostate cancer clinical outcomes. Learning your prostate fate provides an opportunity for screening vigilance, says robotic prostate surgeon, Dr. David Samadi. As Vice Chairman, Department of Urology and Chief of Robotics and Minimally Invasive Surgery at New York's Mount Sinai Medical Center, Dr. Samadi is an advocate of early prostate cancer screening and appropriate, informed treatment planning.

According to Dr. Samadi, ages 45 to 50 are the prime opportunity for men to have their first PSA test. Exact timing depends some on risk factors such as family history of prostate cancer, ethnicity, and weight. “A lot can be learned from that initial PSA test. If it’s normal, great, but if it’s elevated that baseline provides a wealth of information before a man enters his 50’s,” said Dr. Samadi.

Concerns of over-treating or prematurely treating prostate cancer fuel much of the debate surrounding the PSA test. Since not all prostate cancers are fast growing or require immediate action, Dr. Samadi stresses the importance of PSA evaluation by a prostate cancer expert. While the researchers in this Swedish study don’t advocate annual screenings, they do agree that PSA level monitoring is a long-term process.

Dr. Samadi clarifies that the PSA test is not a definitive prostate cancer test. An elevated level does not confirm the presence of prostate cancer, nor is it cause for alarm. Often the blood test is repeated several times to establish a PSA velocity before being followed by a digital rectal exam (DRE) and prostate biopsy.

“We don’t get all the answers from one PSA test. Men with an elevated PSA should repeat the test, pursue other diagnostics, and make an informed treatment decision. If that first test shows a normal level, it’s still wise to develop a follow-up plan with your urologist for more conservative monitoring of your PSA over the years,” advises Dr. Samadi.

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* The benefits of robotic surgery cannot be guaranteed as surgery is both patient and procedure specific. Previous surgical results do not guarantee future outcomes.




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