Prostate cancer is on the increase worldwide and more so among men in Kenya. It’s the 2nd most common cancer in men after lung cancer.
Risk factors increase someone’s chances of getting a disease but are not a direct cause in themselves. Studies have suggested the following as risk factors for prostate cancer:-
- Age – Most patients are over 50 years
- Race – More common in African men than Caucasians
- Family history – Prostate cancer that runs in families accounts for ~20% of cases
- Hereditary Breast /Ovarian Cancer Syndrome
Signs and symptoms
During the early stages, prostate cancer is clinically silent. One of the biggest challenges in the management of prostate cancer is the fact that by the time symptoms appear, the disease is already progressed. Some of the symptoms are:-
- Urinary symptoms
- Perineal pain
- Bone pain
Screening is defined as detecting the presence of disease before its clinically apparent. For prostate cancer, blood levels of the Prostatic Specific Antigen (PSA) have been used as a marker of cancer. It’s however very important to note the test is neither very sensitive nor specific enough and the interpretation must be correlated with other investigations and clinical picture.
What is PSA
This is a protein( enzyme) normally produced by epithelial cells of the prostate. Its normal function is to liquefy the semen and allow sperm to effectively swim towards the ova.
The levels of 0-4ng/ml are taken as normal for adult males. However, the levels are known to change with age, and this should be taken into account when interpreting.
Some of the benign conditions that may cause an increase include-
- Benign prostatic enlargement
- Digital rectal examination
- Post ejaculation
Reference levels for PSA
|Age Bracket (years)||PSA Reference Range (ng/ml)|
Utility of PSA in screening for prostate cancer
In most countries, there are no clear guidelines for the use of PSA for prostate cancer screening. The use and interpretation of PSA levels should be individualized. Extreme care should be taken especially when these tests are advertised as part of “Well-Man Checkups”. False-positive and negative results can lead to patient harm.
Apart from spot levels, velocity or the rate of increase of PSA levels over time are more important. Such an increase may mean cancer has recurred after surgery or radiotherapy treatment.
What is the cost of PSA Cost In Kenya?
The cost of PSA tests in Kenya vary widely based on factors like the type of facility, location and is sometimes arbitrary. In my review, the price ranged from 1600 in public hospitals (KNH) to as high as 5,000 in private, high-end laboratories. The median cost is around KES 2,500.00.
PSA is an important but controversial test in the screening of prostate cancer. It should be used with caution, taking to account all other clinical, and radiological factors when interpreting it.
In case you have any queries about this test, be sure to contact us for a free consultation.