Men’s Health: Should You Be Screened for Prostate Cancer?
Prostate cancer is the most common form of cancer in men. While it’s rarer in men under the age of 50, many men will have some form of the disease as they age. In many cases, prostate cancer
is slow-growing and, depending upon a person’s age, may not pose a health threat.
UR Medicine urology expert Dr. Edward Messing says it's important to learn about early detection.
When prostate cancer is detected in its early stages—when it is limited to the prostate gland—it can be treated with very good chances for survival. Routine screening is highly effective and approximately 85 percent of American men with prostate cancer are diagnosed in the early stages of the disease.
How is it detected?
The current frontline prostate cancer screening tool is a blood test that checks for elevated levels of prostate-specific antigen, or PSA. It’s not precise and can’t distinguish between slow-growing cancers that may not require treatment and more aggressive and dangerous forms. Additionally, some non-cancerous conditions can also elevate PSA. Only one in four men with a high PSA level ends up having cancer. When a man has an elevated PSA level, the primary way to determine if there is aggressive or slow growing cancer—or no cancer at all—is through a biopsy of the prostate gland.
When cancer is detected through a biopsy, men face a range of options depending on the type of cancer. If the cancer is slow growing, the recommended approach is often consists of “expectant management,” meaning no immediate treatment but continued monitoring and perhaps more in the future. However, many men will hear the word “cancer” and want to take action, though treatment options may have risks and side effects, including, erectile dysfunction and, less commonly, urinary incontinence and bowel dysfunction.
Adding to the confusion over PSA screening, various health organizations have recommended different screening guidelines. In reality, deaths from prostate cancer have declined since we began using PSA screening. So, until a better test comes along, it’s still the most effective way to catch prostate cancer at an early stage.
What should men do?
First and foremost, talk to your doctor about PSA screening and when and how frequently it makes sense to take the test. Men at higher risk for prostate cancer should be screened regularly.
Risk factors include:
Age: Your chance of having prostate cancer increases substantially over the age of 50. Most prostate cancers are found in men age 65 or older.
Race: For reasons that are not entirely clear, African American men are at higher risk for prostate cancer than men of other races.
Family history: If a close family member such as your father or brother was diagnosed with prostate cancer at an early age, you are at a higher risk of developing the disease.
Diet: Men who consume a high-fat diet and are obese are at higher risk for prostate cancer.
Early detection of prostate cancer can be a lifesaver. After considering the pros and cons of screening, your age, general health and risk factors, talk to your doctor and together you can make the right decision.
Edward M. Messing, M.D., is the chair of the UR Medicine Department of Urology. A renowned expert in the diagnosis and treatment of cancers of the prostate, bladder, kidney, testicle, penis and other genitourinary organs, he’s done extensive research in the basic biology of bladder and prostate cancers, and has been the principal investigator on numerous clinical studies for the detection, prevention and treatment of genitourinary cancers.