Prostate Cancer: What You Should Know About Screening and Diagnosis

Prostate cancer is one of the most common cancers affecting anyone with an intact prostate. It is caused by the uncontrolled spread of abnormal cells in the gland. Prostate cancer screening is important for early detection, because many of those diagnosed do not show any symptoms. Plus, the earlier the cancer is found, the more treatable it is.

What Screening Tests Are Available?

The following tests are used to check for prostate cancer:

Prostate exam. For this test, also called a digital rectal exam, the doctor inserts a lubricated, gloved finger into the rectum. They feel the surface of the prostate for any lumps, swelling or other abnormalities. This is the most common test to screen for prostate cancer.

PSA blood test. PSA refers to “prostate-specific antigen,” a protein produced by the prostate gland. Older people generally have higher levels of PSA than younger people, as prostate gland size and PSA levels increase with age. Your doctor can tell you if your test results are normal for your age. High levels of PSA may indicate the presence of prostate cancer.

What Are the Screening Recommendations for Prostate Cancer?

Talk with your doctor about the pros and cons of screening for prostate cancer. The following guidelines may help you in talking with your doctor about prostate cancer screening:

Those at average risk of prostate cancer: Start talking with your doctor about prostate screening at age 50.

Those at higher risk of prostate cancer: Starting at age 45, talk with your doctor about what screening schedule is right for you.

Those at highest risk (for example, those who have had several relatives diagnosed with prostate cancer at an early age): Ask your doctor about screening starting at age 40.

What Are the Risk Factors for Prostate Cancer?

Though it is often seen as a male cancer, anyone with an intact prostate is at risk of developing prostate cancer. The following are some of the other known risk factors. Talk to your doctor about your risk.

Age. Prostate cancer is more common among those over 50. Most cases of prostate cancer are diagnosed among individuals age 65 or older.

Race. Black and African American individuals are at a higher risk of developing prostate cancer. The reasons for this remain unclear.

Family history. Having an immediate family member who has been diagnosed with prostate cancer increases your risk. Having several close relatives diagnosed with prostate cancer at an early age puts you at a higher risk.

Genetic mutations. Inherited mutations in the BRCA1 or BRCA2 genes increase risk of prostate cancer, as well as breast and ovarian cancers. For more information, ask your doctor about comprehensive biomarker testing, which may include genetic testing for inherited cancer risk.

Diet. A diet high in animal fat and red meat may increase the risk for prostate cancer.

What Are the Symptoms of Prostate Cancer?

Early-stage prostate cancer usually has no symptoms. If you are experiencing any of the following, check with your doctor, as they may be signs of benign (non cancerous) prostate disease or prostate cancer:

• Frequent urination
• Weak or interrupted urine flow
• Blood in the urine
• The urge to urinate frequently at night
• Pain or burning during urination

Edited by Marissa Fors, MSW, LCSW, OSW-C, C-ASWCM, CCM