Prostate Screening Choices

IMAGEProstate cancer is one of the most common cancers in the United States. It is a cancer of the prostate gland, which is only found in men. This gland sits below the bladder. In most cases, men with prostate cancer are over 65 years of age, but it can occur in younger men. In its early stages, prostate cancer has no symptoms. It is often a slow-growing cancer. In fact, it may take years to develop. As the cancer gets larger or spreads, it may cause problems. This may include impotence , urinary problems, and pain in your back, hip, or thighs. To help detect cancer in its early stages, your doctor may recommend a prostate specific antigen test (PSA) and a digital rectal exam (DRE).

PSA Test

The United States Preventive Services Task Force (USPSTF) and the American Academy of Family Physicians (AAFP) do not recommend PSA tests to screen for prostate cancer in men of any age. Other organizations, such as the American Urological Association, recommend that it be a decision a man can make after discussing the risks and benefits with his doctor. The changes made to screening guidelines in 2012 led to controversy, especially since the PSA test was widely used to screen for cancer. Take the approach that you feel most comfortable with. It is important to know your history, your family's history, your risk, and your comfort level. PSA is made by the prostate gland. A PSA test measures the level of the antigen in your blood. It is done with a sample of blood, which can be taken at your doctor’s office during a regular physical exam. It is normal for healthy males to have some PSA in their blood. Levels sometimes increase when prostate cancer is present. There are other conditions which may increase the PSA. They include an prostatitis or benign prostatic hypertrophy (BPH). BPH is a benign (non-cancerous) prostate enlargement. It is often found in older men. If your PSA increases, your doctor may order further tests. PSA may also be checked in people who have already been diagnosed with cancer. PSA may be used to check the progress of cancer or to evaluate treatment.Key considerations:
  • Both benign and cancerous conditions can cause elevated PSA levels.
  • The blood test can only measure the levels, not the cause. Further testing would need to be done to find the cause.
  • Prostate cancer does not always increase PSA levels. A test that shows normal levels does not mean you are cancer-free. Do not ignore symptoms common to prostate cancer because you had a normal PSA test. This could lead to a delay in treatment.

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