For patients with elevated PSA results, they are usually preferred to undergo biopsy for further diagnosis. However, the problem of false positive PSA has always been a headache, and it is not good to know the taste of prostate biopsy. Recently, Dr. Gerald Chodak expressed his views on how to reduce unnecessary biopsy. He believes that there are still some ways to provide...
For patients with elevated PSA results, they are usually preferred to undergo biopsy for further diagnosis. However, the problem of false positive PSA has always been a headache, and it is not good to know the taste of prostate biopsy. Recently, Dr. Gerald Chodak expressed his views on how to reduce unnecessary biopsy. He believes that there are still ways to provide clinicians to try to reduce the number of biopsies, such as by performing repeated PSA tests.
Lavallée and his team conducted a prospective assessment of 1,300 Canadian patients. Lavallée wants to find out if the PSA is at 4 to 10 ng/ml and the PSA is tested at the same time before the biopsy. It was found that after repeated PSA testing, approximately 25% of patients had PSA values ​​falling below 4 ng/ml. A total of 89 patients underwent prostate biopsy and 26 patients with cancer were diagnosed. The detection rate was 8.3%, which was lower than 35% when no PSA was repeated.
After a second test of PSA, a portion of patients who could not actually undergo a prostate biopsy were excluded. Responsibly, the trial did not provide a clear solution, but it provided a way of thinking: If there is any way to reduce the number of unnecessary prostate biopsy, why not try it?
The American Urological Association (AUA) has advised clinicians not to decide whether a patient will undergo a biopsy based on a single PSA result. Doctors should have multiple PSA tests on patients, especially those who have not had a biopsy before and who have no family history of prostate cancer.
There are also some trials that support the AUA's recommendation, and the researchers of the trial have pointed out the fact that the PSA value fluctuates. Of course, this involves cost issues, and doctors need to think about how to give patients a second check. Because in general, the cost of performing a second PSA test is lower, and the most important thing is to avoid part of the patient's suffering.
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