By: Rajiv Tewari with inputs from Dr Shafiq Ahmed, Director and Senior Consultant at Narayana Super-speciality Hospital. Detailed introduction of Dr Shafiq is given towards the end of the article.
While regularly visiting the Narayana Hospital in Gurgaon for one of my relatives, I was amazed to discover how ignorant I was about a simple test like PSA though I am already 60 + and have worked in the healthcare sector for over a decade.
Dr Shafiq Ahmed, Director and Senior Consultant at Narayana Super-speciality Hospital shared his experience and made me aware about how this lack of awareness causes avoidable misery and huge financial, physical and emotional pain for the patient as well as the family. He is on a mission to educate people on how cancer cure is possible in most cases if detected early. I got a PSA test done and thankfully the report was negative.
Simply include a PSA screening test in your health check-up plan
One of my LinkedIn contacts too has recently shared a post describing how he was diagnosed for Prostate Cancer over 15 years back and how he is enjoying a happy life with his grandchildren. Another contact shared how a simple life saving test like the PSA is ignored in the health check-up packages. The very mention of the word cancer is scary though it’s a curable disease if detected early. All you need to do is to add this test to your regular health check plan.
According to The Indian Council of Medical Research (ICMR) data on the incidence rate of prostate cancer in India is 9-10/100000 population. This is higher compared to many countries in Asia and Africa, but lower compared to the US and Europe.
Guidelines for PSA screening
The general guidelines recommend a PSA Screening starting at age 50 Years + however you may need PSA screening even at 40+ if you have a close relative who has had prostate cancer. Though in most cases a PSA test once in two years is enough, in certain cases your Doctor may recommend a higher frequency. It’s important to note that no screening is required after 75 Years of age however clinical examination may be required if there are any symptoms. So even after attaining the age of 75 Years it is important to consult the Oncologist after your general health check-up.
PSA testing can be done with a simple blood test but the report may not be 100% accurate so it is important to get the test reports cross checked by the Doctor who may in certain cases recommend further tests on the basis of the size of prostrate, frequency of change in the PSA levels & the medications you may be taking. In some cases the Doctor may recommend a PSA test along with DRE (Digital Rectum Examination).
Most cases of prostate cancer may not be detected early due to lack of significant symptoms. The symptoms may appear once it has spread to the bones and other organs of the body. The main causes are lack of awareness, avoidance of annual health check-ups and a tendency towards self-denial due to male ego.
What does a PSA test reveal?
For men in their 40s and 50s, a PSA score greater than 2.5 ng/ml is considered abnormal. Median PSA range for this age group is 0.6 to 0.7 ng/ml.
For men in their 60s, a PSA score greater than 4.0 ng/ml is considered abnormal. Normal range is between 1.0 and 1.5 ng/ml.
A PSA score can be considered abnormal if it indicates a rise every year. If your score rise is more than 0.35 ng/ml in a year then further testing may be required. If the PSA score is in the abnormal range then the PSA test may be repeated for a reconfirmation. If it is still found higher than the Doctor may assess your risk profile and go in for a biopsy or for the new blood, urine and imaging tests that are available now.
Warning signs of prostate cancer requiring immediate attention
- Painful & burning sensation during urination or ejaculation.
- Problem in stopping or starting urination
- Sudden erectile dysfunction.
- Frequent urination during the night is another sign however this could be age related too but a consultation with the Doctor is required to rule out cancer.
- Blood in urine or semen.
- In some cases symptoms of this cancer may be in the form of sudden retention and total inability to pass urine, loss of bladder control, swelling in the pelvic region, leg or feet numbness, bone pain and fractures of the bone even with minor injuries.
About Dr Shafiq Ahmed
Dr Shafiq Ahmed is Director and Senior Consultant at the Narayana Super-speciality Hospital, Gurugram though he visits all the centers of the group hospitals across North India. He is an US credentialed robotic uro-oncologist and specializes in robotic radical prostatectomy, robotic radical cystectomy and robotic partial nephrectomy for treatment of patients suffering from prostate, urinary bladder and kidney cancers in addition to general urologic problems in men and women. An MBBS, MS (Surgery), DNB (Urology), MNAMS with 15 publications, including 3 book chapters, to his credit in leading medical journals and with work experience at some of the most respected hospitals in India.