Men's Sexual Health > Prostate Cancer
- Written by H. Ballentine Carter, M.D. (Medically Reviewed)
The prostate-specific antigen (PSA) test is one of the most familiar of urology's milestones. Millions of men have benefited from early prostate cancer detection because of this revolutionary (albeit somewhat controversial) blood test. Yet, given urology's centuries-old timeline, the research that produced this simple tool is relatively recent. Before 1986, when the Food and Drug Administration approved the PSA test for monitoring prostate cancer, no blood test existed to screen for the disease.
In the past, the digital rectal exam was the only screening available and would detect cancer often when tumors were too advanced for cure. Prostatic acid phosphotase (PAP) proved to be a sensitive blood-serum marker for advanced malignancies, but did nothing for early detection since it missed localized tumors.
So there's little surprise that the discovery of prostate-specific antigen, an enzyme manufactured by the prostate and secreted in excess into the bloodstream when cancer is present, would turn into such a valuable screen for men over age 50.
The PSA test is the product of many minds collaborating over many decades. In 1970, immunologist R.J. Ablin, of the State University of New York, Buffalo, initially observed PSA. Roswell Park's T. Ming Chu, with other investigators, set out to extend Ablin's observations. Their goal? To develop a blood test for early prostate-cancer detection.
In 1979, Chu's colleagues, led by M.C. Wang, characterized and purified the antigen, and in 1980, Lawrence D. Papsidero and fellow scientists confirmed its presence in the blood of prostate cancer patients. Amidst that activity, Chu introduced the PSA test, a screen that picks up early malignancies by detecting elevated levels of PSA in the blood.
William Cooner, of the University of South Alabama, and William Catalona, of Washington University, produced separate landmark studies in 1990 and 1991, respectively showing that combining PSA tests with digital rectal exams is the most effective way to detect prostate cancer.