The prostate-specific antigen blood test for prostate cancer has become controversial in recent years due to its questionable reliability. It also isn’t clear that the benefits of PSA screening outweigh the risks of follow-up diagnostic tests and cancer treatments.
False-positive test results – when a man has an abnormal PSA test but does not have prostate cancer – often lead to unnecessary tests including an invasive biopsy of the prostate, which carries its own risk including bleeding, pain and infection. The results can also lead to false-negative results, missing the malignancy and providing false reassurance. The PSA test also fails to tell the difference between slow-growing and fast-growing cancers.
PSA is a protein produced by both cancerous and noncancerous tissue in the prostate, a small gland that sits below the bladder in males. It is mostly found in semen, which also is produced in the prostate. Small amounts of PSA ordinarily circulate in the blood.
The PSA test can detect high levels of PSA that may indicate the presence of prostate cancer. However, many other conditions, such as an enlarged or inflamed prostate, also can increase PSA levels. Therefore, determining what a high PSA score means can be complicated.
There is a lot of conflicting advice about ordinary PSA testing. To decide whether to have a PSA test, men should discuss the issue with their doctor, consider their risk factors and weigh their personal preferences.
A new breakthrough in predicting prostate cancer
A new study conducted at the Cleveland Clinic in Ohio – one of the world’s leading cancer treatment centers – has led to a breakthrough in predicting prostate cancer using a blood test. The study showed that men who underwent an early diagnosis using a new blood test called IsoPSA and received a normal result in both the blood test and the biopsy have just a 1% risk of developing aggressive prostate cancer within 18 months (the follow-up time in the study).
The new study was recently published in the medical journal Urology Times, the leading multimedia resource for urologists and allied health professionals. It was presented at the 2023 American Society of Clinical Oncology Genitourinary Cancers Symposium held in the middle of February in San Francisco. IsoPSA was presented as a new and reliable blood test with an accuracy of over 90% that makes it possible to predict aggressive prostate cancer. The new test is already available in Israel to members of most health funds who carry supplementary health insurance policies. The blood test also allows most patients to avoid a biopsy, which is an invasive operation performed under full anesthesia.
The new test is intended for men ages 50 and over with a PSA level higher than four and a referral from a urologist. Cleveland Diagnostics has secured breakthrough-device designation from the US Food and Drug Administration for its IsoPSA assay to detect prostate cancer.
“These are very important results since a biopsy does not detect about 15% to 20% of cases of aggressive prostate cancer. If an IsoPSA test is performed and it’s normal, the risk of developing a clinically significant tumor decreases to a negligible 1%. Moreover, the risk of failure also decreases, not only at the time of the test but also for the next 18 months.”
Prof. Ofer Nativ
Prof. Ofer Nativ – a senior urologist at Haifa’s Elisha Hospital and a former director of the Urology Department at the nearby Bnei Zion Medical Center, who serves as a scientific adviser for testing in Israel – said, “These are very important results since a biopsy does not detect about 15% to 20% of cases of aggressive prostate cancer. If an IsoPSA test is performed and it’s normal, the risk of developing a clinically significant tumor decreases to a negligible 1%. Moreover, the risk of failure also decreases, not only at the time of the test but also for the next 18 months.”
Prostate cancer is the most common cancer among men in Israel. According to data of the Israel Cancer Society, about 2,700 new patients are diagnosed every year. According to the Health Ministry, prostate cancer constitutes about 21% of all cancerous tumors among Jews and 11% among Arabs.
The IsoPSA test is offered in Jerusalem, Tel Aviv, Herzliya, Rishon Lezion, Haifa, Beersheba and Karmiel. Information can be obtained online at isopsa.co.il or at *5901.