The PSA test can detect a tumor on average 11 years earlier than a rectal exam. But some doctors and epidemiologists argue that there's little evidence that widespread PSA testing is actually saving lives. That's because some tumors grow aggressively, but others grow slowly and are never a problem, and doctors often can't tell the two apart. The most common therapy for prostate cancer, radical prostatectomy, which removes the gland at the base of the penis, comes at a high cost. Incontinence is also common.
Complications are lower in patients who undergo radiation treatments.
Though most physicians believe that surgery is the safest course, men contemplating PSA test results should understand their options. This month, scientists at Memorial Sloan-Kettering Cancer Center said they had found p27, a genetic marker that may one day help detect the aggressive prostate tumors.