Many men die each year from prostate cancer without ever experiencing symptoms. Prostate cancer screening can help identify the disease early on, when treatment is most effective. There are many different recommendations for prostate cancer screening from many medical organizations. There is also debate over the benefits of screening. The most important step you can take is to discuss screening with your doctor to determine the best plan based on your health and risk level.
The prostate is a walnut-sized gland that produces seminal fluid that transports sperm. All men are at risk for prostate cancer. Age is the most common risk factor. The older a man is, the greater the chance of getting prostate cancer. Out of one hundred American men, about thirteen will get prostate cancer during their lifetime, and about two to three men will die from prostate cancer, according to the Centers for Disease Control and Prevention.
Symptoms of prostate cancer include:
- Difficulty starting urination
- Weak or interrupted flow of urine
- Frequent urination, especially at night
- Difficulty emptying the bladder completely
- Pain or burning during urination
- Blood in the urine or semen
- Pain in the back, hips, or pelvis that doesn’t go away
- Painful ejaculation
Two tests can detect prostate cancer when there are no symptoms. During a digital rectal examination (DRE), a doctor manually checks the prostate for abnormalities through the wall of the rectum. The second type of screening measures prostate-specific antigen (PSA) in the blood. If a screening comes back positive, the next steps are a biopsy to diagnose and a subsequent treatment plan.
When found early, it may be easier to treat and cure prostate cancer. Prostate cancer screenings are recommended for men at 50 years old. Men at higher risk, including African American men and men who have a first-degree relative (father or brother) diagnosed with prostate cancer before age 65, should be screened at age 45. Men at a very high risk (multiple family members diagnosed with prostate cancer before age 65 years) should be tested at age 40.
The American Society of Clinical Oncology discourages screenings for those who are expected to live less than 10 years. Those with a longer life expectancy should discuss the risks and benefits of screening with their doctor.
If you are thinking about being screened, you and your doctor should consider:
- If you have a family history of prostate cancer
- If you are African-American
- If you have other medical conditions that may make it difficult for you to be treated for prostate cancerif it is found, or that may make you less likely to benefit from screening
- How you value the potential benefits and harms of screening, diagnosis, and treatment