HIgh level of PSA in blood is supposedly associated with prostrate cancer, the problem is that the association is not always correct. The benefit of prostrate biopsy in patients with borderline and moderately increasd PSA (4.0 - 10 ng/ml ) and Free : Total PSA ratio more than > 0.25 to diagnose prostrate cancer is doubtful and risky procedure as the biopsy may actually aggravate a dormant prostrate cancer. During a needle biopsy a tumour may need to be punctured several times to retrieve an amount of tissue that is adequate enough to be screened.
Moreover the penetration itself may spread cancer cells into the track formed by the needle or by spilling cancerous cells directly into the blood stream or lymphatic system.Can we rely only on the non invasive investigations i.e. PSAFT, PSAV, PSADT and DRE for screening of prostrate cancer in elderly patients with BPH
