MikeLigalig.com

By Honor Blanco Cabie

This month, employees of a government news organization have been assigned dates within which to have an appointment with doctors at the Philippine Cancer Society in Manila’s San Miguel district – for detection of prostate and breast cancer.

Many have started queuing up for the appointment – but as many, chiefly those in their 50s, 60s and some employment extendees, refused to meet up with the doctors for fear they might learn they had something literally “bellow their belt.”

But registered medical technologist Joy Luz Roque echoed what urologist Renato Tongol of San Fernando City, Pampanga and other medical experts have said that early detection of cancer was “still the best cure. “

And this is particularly important for those who have a highly processed diet, smokers, compulsive drinkers and journalists who have a sedentary lifestyle in an eminently stress-filled newsroom.

The first batch of employees had a similar observation on how the doctors began the examination: they were separately asked for their medical history, precisely to find out what possible symptoms might have been experienced by the patient in the near- or even long-term.

The rectal exam, which lasts less than a minute, may be chased by an ultrasound or a prostate-specific antigen test, which measures, according to the National Cancer Institute (NCI), the blood level of PSA, a protein that is produced by the prostate gland.

According to NCI, the higher a man’s PSA level, the more likely it is that he has prostate cancer although there are other reasons for having an elevated PSA level, and some men who have prostate cancer do not have elevated PSA.

NCI says the PSA test has been widely used to screen men for prostate cancer. It is also used to monitor men who have been diagnosed with prostate cancer to see if their cancer has recurred (come back) after initial treatment or is responding to therapy.

But some advisory groups now recommend against the use of the PSA test to screen for prostate cancer because the benefits, if any, are small and the harms can be substantial. None recommend its use without a detailed discussion of the pros and cons of using the test.

But what is the PSA test?

Prostate-specific antigen, or PSA, a protein produced by cells of the prostate gland, measures the level of PSA in a man’s blood.

According to cancer experts, for this test, a blood sample is sent to a laboratory for analysis. The results are usually reported as nanograms of PSA per milliliter (ng/mL) of blood.

NCI says the blood level of PSA is often elevated in men with prostate cancer, and the PSA test was originally approved by the FDA in 1986 to monitor the progression of prostate cancer in men who had already been diagnosed with the disease.

In 1994, the Federal Drug Association approved the use of the PSA test in conjunction with a digital rectal exam (DRE) to test asymptomatic men for prostate cancer.

Men who report prostate symptoms often undergo PSA testing (along with a DRE) to help doctors determine the nature of the problem, according to NCI.

In addition to prostate cancer, several benign (not cancerous) conditions can cause a man’s PSA level to rise. The most frequent benign prostate conditions that cause an elevation in PSA level are prostatitis (inflammation of the prostate) and benign prostatic hyperplasia (BPH) (enlargement of the prostate).

There is no evidence that prostatitis or BPH leads to prostate cancer, but it is possible for a man to have one or both of these conditions and to develop prostate cancer as well, according to NCI.

Until recently, many doctors and professional organizations encouraged yearly PSA screening for men beginning at age 50. Some organizations recommended that men who are at higher risk of prostate cancer, and men whose father or brother had prostate cancer, begin screening at age 40 or 45.

However, as more has been learned about both the benefits and harms of prostate cancer screening, some organizations have begun to caution against routine population screening.

Although some organizations continue to recommend PSA screening, there is widespread agreement that any man who is considering getting tested should first be informed in detail about the potential harms and benefits.

What is a normal PSA test result?

According to cancer specialists, there is no specific normal or abnormal level of PSA in the blood. In the past, most doctors considered PSA levels of 4.0 ng/mL and lower as normal.

If a man had a PSA level above 4.0 ng/mL, doctors would often recommend a prostate biopsy to determine whether prostate cancer was present, according to experts.

Roque, who arranged the appointments for the government news organization employees, said people should have themselves checked at the first signs of the problem, the symptoms, including but are not limited to blood in the stool, changes in bowel movement, unexplained weight loss, unexplained anemia, and frequent abdominal pain.

She says that given the present fast pace and ever changing lifestyles, particularly those in the metropolis, early detection of cancer, among the top leading causes of morbidity and mortality in the Philippines, remains the best weapon against the disease.

According to cancer specialists, leading cancer sites or types are lung, breast, cervix, liver, colon and rectum, prostate, stomach, oral cavity, ovary and leukemia.

Figures from the Philippine Cancer Society show deaths in year 2010 in the different cancer types as: lung, 9,184; liver, 6,819; breast, 4,371; intestines, 3,060; leukemia, 2,609; stomach, 2,274; cervix, 1,984; brain, 1,855; prostate, 1,410; and pharynx, 1,326.

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