Relación entre psa y cáncer de próstata, primera parte.

El Antígeno Prostático Específico (PSA) es un marcador en sangre de la próstata que valora la probabilidad de que haya un cáncer de próstata. Es una de las pruebas que más solicitamos los urólogos; muchos pacientes a partir de 50 años acuden a nuestras consultas para realizarse este análisis de forma anual.

El British Medical Journal acaba de publicar un artículo valorando la idoneidad de realizar este test sanguíneo a todos los hombres mayores de 50 años, concluyendo que puede tener efectos más negativos que positivos en la población general.
El cáncer de próstata es el cáncer más frecuentemente diagnosticado en los hombres, lidera la mortalidad por cáncer en 24 países, es el octavo globalmente en mortalidad y el sexto en los países ricos.

El PSA es una sustancia que se puede elevar por la presencia de un cáncer de próstata, pero también por el crecimiento benigno de la próstata (Hiperplasia Benigna de Próstata). Por tanto, es un marcador de la próstata pero no es específico del cáncer, puesto que muchos hombres con bajos niveles de PSA también son diagnosticados de cáncer.

Si el PSA en los análisis está elevado, por lo general, debe repetirse la prueba sanguínea para verificar su elevación. En caso de persistir aumentado, el paciente suele ser sometido a una biopsia de próstata. Hoy en día se realiza cada vez con más frecuencia una prueba de imagen específica, la resonancia multiparamétrica de próstata, que permite determinar con mayor precisión la posible presencia de este cáncer y su localización en la próstata. En caso de solicitar una biopsia, la resonancia permite afinar mucho más la toma de muestras frente a la biopsia tradicional, que se realiza de forma aleatoria.

Por muchas razones, la determinación del PSA en todos los hombres es controvertida y tiene muchos detractores en contra. En los próximos artículos, debatiremos esta cuestión.

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