Prevention, a pillar of good health, includes screening to detect and treat diseases early. There is debate, however, about the value of prostate cancer screening for men who have no symptoms.
Although such screening may lead to early detection and treatment, it may also reveal cancer that needs no treatment. You and your doctor will base the benefits of screening on your individual risk, age, overall health, and desire for treatment should you receive a prostate cancer diagnosis.
How common is prostate cancer?
Next to skin cancer, prostate cancer is the most common type of cancer. It is the second leading cause of cancer death among American men, according to the National Cancer Institute. The American Cancer Society estimates that 1 in 9 men will receive a prostate cancer diagnosis.
But, most men with prostate cancer do not die from it. The Prostate Cancer Foundation reports that approximately 95% of all prostate cancers are detected when confined to the prostate, and treatment success rates exceed those of most other cancers. The five-year survival rate in the United States for men diagnosed with prostate cancer is 99%, the Foundation says. Still, there are aggressive forms of the disease, which is why you and your doctor must carefully weigh the benefits of screening.
Prostate cancer occurs mainly in men aged 65-74, and the chances of developing it increase with age. It occurs most commonly in African-American men, followed by Hispanic, Native-American, and Asian-American men. In addition to age and race, your risk may increase if your father or brother had the disease.
You can help lower your risk of prostate cancer by eating a low-fat diet with plenty of fruits and vegetables.
The Prostate Cancer Foundation (PCF) recommends beginning annual screening at age 50 if you have no prostate-related symptoms or family history and are not African American. If you are African American, the PCF recommends you begin screening at age 45. If you have a family history of prostate cancer, you should begin at age 40. Consult your doctor if you are 55 to 69 and have no symptoms.
What screening entails
The PSA test and the digital rectal exam (DRE) are the most common screening tests. The PSA test measures prostate-specific antigen (PSA) in your blood, while the DRE allows your doctor to determine if your prostate is enlarged or irregular.
Prostate enlargement and elevated PSA levels could be signs of prostate cancer or solely because of aging. PSA tests can also falsely produce positive results (false-positive), leading to unnecessary tests and procedures; or negative (false-negative) results, creating a misleading sense of security. Abnormal test results may persuade your doctor to repeat them and suggest an ultrasound or tissue sampling.
Symptoms of prostate problems
See your doctor if you have:
- Frequent urge to urinate awakening you throughout the night
- Blood in urine
- Pain or burning when you urinate
- Weak urinary stream
Together, you and your doctor will decide if prostate cancer screening is right for you.