Prostate cancer is the most common form of cancer in the United States, apart from skin cancer. That’s why it’s important for men to have regular prostate cancer screenings. Here’s how to do it.
The prostate is a gland in all men, about the size of a walnut, found below the bladder and in front of the rectum. It produces a fluid that is found in semen.
Prostate cancer is typically found in older men, but can also develop in younger men. In many, the cancer is relatively slow growing, but in others it can be quite aggressive. Risk factors for developing prostate cancer include being over 50, being black, having a relative with prostate cancer and having a diet high in fat or alcohol.
Ideally we would be able to find all prostate cancers while they are still at an early stage and can be treated effectively. Currently, the most common screening tests are the prostate specific antigen (PSA) test and the digital rectal examination (DRE). Both tests are often done at the same doctor visit, usually during an annual medical exam.
PSA is a substance that is created by the prostate gland. In men with prostate cancer, the PSA level may be higher than normal. A PSA level may be determined from a routine blood test. Screening by PSA measurement can be done yearly. Typically, if your PSA levels are elevated, further evaluation is done by performing a biopsy of the prostate.
The digital rectal examination (DRE) is performed by your physician in the office. He or she is able to feel the prostate gland for lumps or nodules. Abnormalities may require further testing, usually a biopsy.
Admittedly, these screening tests are not perfect and have limitations. There is the possibility for false positive tests (which may result in unnecessary follow up testing or surgery) or false negative tests (which may result in missed cancers). Also, sometimes screening will detect a cancer that is so slow growing that it never would have caused any problems. Furthermore, screening tests have not definitively been shown to reduce mortality from prostate cancer.
So what are the current recommendations? Most medical authorities suggest offering prostate cancer screening (by PSA and DRE) as an option for those over age 50 or earlier if you are in a high risk group. Screening can be done yearly up to age 75 or later if you are otherwise in good health.
r Cameron McKay
