Should You Get Screened for Prostate Cancer?

What Is Prostate Cancer Screening?

The point of any cancer screening is to find cancer before it causes symptoms or spreads. This is especially important when it comes to prostate cancer, as many men don’t experience any symptoms in the early, most treatable stages. Screening is usually the only way to find it.

Prostate cancer is the second-most common cancer for men in the U.S. It’s also 100 percent treatable if found early.

How Do You Screen for Prostate Cancer?

There are two components of a prostate cancer screening. Your doctor will perform a digital rectal exam to feel for any enlargements or lumps in the prostate. He or she will also do a prostate-specific antigen (PSA) test. 

PSA is a substance your prostate makes. The test measures the level of PSA in your blood. As a general rule, having a high PSA indicates a problem with the prostate.

What Are the Risks of Prostate Cancer Screening?

Having an abnormal PSA level doesn’t mean you have prostate cancer. High PSA levels can be an indication of other conditions, such as an enlarged prostate or a prostate infection. Factors such as age, race and use of certain medicines can also affect PSA levels.

A false positive PSA test result often leads to more tests, which may be unnecessary.

The only way to know if an abnormal test is due to cancer is to do a biopsy, in which doctors remove a small piece of tissue from the prostate and look at it under a microscope.

A prostate biopsy can cause:

• Pain
• Blood in the semen
• Infection

What Are Side Effects of Prostate Cancer Treatment?

Many prostate cancers grow slowly and don’t cause any health problems. That’s why in many cases, doctors will recommend observation or surveillance – testing patients regularly and treating the cancer only if it grows or causes symptoms.

For those with more advanced or aggressive disease, the most common treatments are surgery to remove the prostate and radiation therapy. 

Side effects of radiation therapy or surgery may include:

• Impotence
• Loss of bladder control
• Bowel problems

Who Should Be Screened for Prostate Cancer?

According to the CDC, for every 1,000 men between the ages of 55 and 69 years old who are screened, about one death will be prevented. And for three men, prostate cancer will be prevented from spreading to other places in the body.

If you are in this age range, you should make an informed decision with your health care provider about whether to be screened for prostate cancer. You should review the uncertainties, risks and potential benefits of screening and treatment. 

If you are age 45 and older, and you are at high risk of developing prostate cancer, start the conversation with your provider sooner. You may be considered high-risk if you:

• Are African American. African American men are more likely to get prostate cancer, and they are more than twice as likely to die from prostate cancer as white men. African American men also tend to get prostate cancer at a younger age, have more advanced disease when it is found and have a more severe type of prostate cancer than other men.
• Have a first-degree relative (father, son or brother) diagnosed with prostate cancer before age 65.
• Have more than one first-degree relative or two close relatives on the same side of the family diagnosed with prostate cancer. This may indicate inherited genetic changes.
• Have a known inherited gene mutation such as the BRCA1 or BRCA2 gene. 
• Have symptoms of prostate cancer.

Because prostate cancer often grows slowly, men over the age of 70 and those without symptoms of prostate cancer who do not have a 10-year life expectancy typically will not be offered testing since they are not likely to benefit. Overall health status is important when making decisions about screening.

What's Next?

Whether you're thinking about being screened or need more information, contact your Methodist Physicians Clinic primary care provider to discuss your prostate cancer risk.