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Prostate Cancer Symptoms

A new weapon for men in the fight against prostate cancer. Prostate cancer deaths are decreasing, but the need for a more sensitive screening tool has only intensified.

Dr William Catalona, Northwestern Medicine urologist: “The PSA test really looks for a disease state in the prostate. It could be cancer, it could be benign enlargement or it could be infection.” 

It’s a numbers game, not an exact science. There are variables when it comes to estimating a man’s risk of prostate cancer — sorting through them all starts with a blood draw. The sample is sent to a lab where a machine measures prostate-specific antigen — or PSA — a protein that typically increases when cancer is present. Men who have levels in the range of 4 to 10 may opt to have a biopsy, but benign conditions like inflammation and infection also boost the number.

Dr William Catalona: “One of the problems with the PSA test is it’s not specific for cancer, and so many patients who don’t have cancer get a false alarm and undergo a biopsy that is really unnecessary.”

It’s a downside of the PSA test that frustrates doctors and patients alike. Up to 75% of patients undergo unnecessary biopsies.

Howard Ellman, patient: “It’s not the most comfortable thing in the world, and two, there is the possibility of having some negative side effects.”

Howard Ellman has had two biopsies – both came back negative. Yet his levels continue to rise.

Howard Ellman: “Even though I’ve had negative biopsies, there’s still the concern that maybe there’s something going on there.”

Dr Catalona: “So the question is, is he going to have yet another biopsy?”

The Prostate Health Index – or PHI — test will help answer that question. The new screening tool – available for the first time — measures a more sensitive marker in the blood.

Dr Catalona: “This particular marker, the pro-PSA, tends to be elevated more in men who have cancer than in men who have benign conditions. And among the men who do have cancer, it tends to identify those who have the more aggressive forms of prostate cancer.”

Dr Catalona has studied the PHI test for a decade.

Dr Catalona: “We looked at how many men would need to have biopsies if we just used the PSA test or if we used the PHI test. It turns out it saves about 30% of the unnecessary biopsies.”

Howard will learn the results of his PHI test in the next 10 days.

Howard Ellman: “I’m hoping the test shows that they don’t think cancer is the cause of my rising PSA.”

NorthwesternMemorialHospital in Chicago is one of only two facilities in the U.S. offering the test right now, but it will soon be available throughout the country in March. To learn more, go to, or call 312-695-8146

Chicago Prostate Cancer Center thinks Dr. Catalona makes a very good point about patients who have undergone a standard transrectal biopsy with negative results, yet continue to have a rising PSA. What should you do?  Fortunately, Chicago Prostate Center has developed Stereotactic Transperineal Prostate Biopsy or STPB. This is the most comprehensive, sophisticated prostate biopsy technique available, diagnosing 40% more cancer than the standard office procedure—cancer that would have otherwise gone undetected.

Many of the cancers missed by the standard transrectal biopsy are in the apex of the prostate gland. The apex of the prostate gland is located at the bottom of the gland. The transperineal approach can reach all areas of the prostate, giving patients the confidence that if there is a cancer, it will be detected with STPB.  For more information, visit

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