Men who receive a diagnosis of prostate cancer are faced with a frightening array of options.

To live with cancer might seem to be unthinkable, however, in light of the alternatives a slow growing cancer may be easier to live with than the side effects of cancer treatment and in the worse case, death from infection and other surgical complications.

Many men who agree to a PSA test do not understand what it is. Some common misconceptions:

— It shows cancer. In fact, PSA is just a measure of inflammation, and it can be elevated for many reasons besides cancer: normal enlargement of the prostate with age, an infection, even recent sex, a strenuous bike ride or horseback riding.

— It’s been proven to save lives. Only two large, well-done studies have looked at this, the task force says. The American study found annual screening did not lower the chances of dying of prostate cancer. However, cancer fear is so great, and belief in the value of screening so ingrained, that half the men assigned to the group not offered PSA tests got one anyway. That made comparisons to the group given annual screening difficult. For that reason, some doctors don’t believe the study’s conclusion.
The other study, conducted in Europe, found a small benefit for certain age groups screened every two to seven years — not annually. However, one Swedish center had such rosy results that scientists think it may have biased the whole study. If that center is excluded, no benefit from the PSA test is seen.

— The task force’s stance goes against past advice. Routine PSA testing has been supported by some advocacy groups and by urologists, the doctors who do the tests and treatments. But it has not been pushed by major scientific groups, the American Cancer Society or the government.

— It finds cancer early so you’re more likely to survive. About 90 percent of prostate cancers found through screening are early-stage. Most will grow so slowly they will never threaten a man’s life, but there’s no good way to tell which ones will. Research suggests that tumors causing symptoms are more likely to warrant treatment than those that are not. Also, finding aggressive prostate tumors early may not affect how lethal they prove to be; the PSA test may just let men learn of them sooner than they otherwise would.

According to a new study from University of Michigan discover how prostate cancer cells spread to the bones. Science offers hope for the treatment of prostate cancer

So why does cancer recur? Say a person has a tumor and surgeons cut it out or do radiation, but it recurs in the bone marrow five years later, Taichman said. Those cancer cells had been circulating in the body well before the tumor was discovered, and one place those cancer cells hid is the niche.

“So what have the cancer cells been doing during those five years? Now we have a partial answer — they’ve been sitting in this place whose job it is to keep things from proliferating and growing,” Taichman said.

“Our work also provides an explanation as to why current chemotherapies often fail in that once cancer cells enter the niche, most likely they stop proliferating,” said Yusuke Shiozawa, lead author of the study. “The problem is that most of the drugs we use to try to treat cancer only work on cells that are proliferating.”