Q: Should I get checked for prostate cancer even if I have no symptoms?
A: The American Cancer Society recognizes prostate cancer as the most common cancer among American men. About one in seven men will be diagnosed with prostate cancer during his lifetime, yet nearly all men with early-stage prostate cancer survive five years or longer after diagnosis. This is, in part, thanks to early detection from regular screenings.
Some experts believe that PSA screening may do more harm than good because of the risks of treatment, particularly incontinence and impotence. Medical and public health groups, including the American Cancer Society, recommend that before getting screened, men should discuss the risks and benefits with their health care providers, taking into consideration their personal values.
Age, ethnicity, and family history are the biggest factors that affect your likelihood of developing prostate cancer. Before age 40, prostate cancer is rare; however, as you grow older, prevalence increases dramatically. By age 60, one in every 14 men will develop the disease. The Cancer Society recommends starting annual prostate cancer screenings at age 50 if you are of average risk, and earlier if you are at increased risk, such as those who are genetically predisposed to develop prostate cancer.
African American men are 1½ times more likely to develop prostate cancer than Caucasian or Hispanic men. Additionally, men with an immediate family history of prostate cancer, such as a father or brother who has the disease, have a doubled risk of developing it. Men with one or more of these factors should consider screenings before age 50.
Screening for prostate cancer consists of two simple tests: a digital rectal exam and a prostate specific antigen (PSA) blood test.
Digital rectal exam: Your doctor manually feels the size and texture of the prostate to determine whether there are any lumps or abnormalities.
PSA blood test: Your doctor measures the level of PSA in the blood. PSA is a protein made only by the prostate, and is produced in larger amounts by prostate cancer. PSA can be affected by other factors, including certain medications, prostate size and inflammation, and varies from person to person. Tracking the way your PSA level changes over time is very informative. An abnormally high PSA level may indicate the presence of prostate cancer and require further tests by your doctor.
Talk to your doctor about whether prostate cancer screening is appropriate for you.
Noah R. May, D.O., is a urology associate at Mercy Fitzgerald and Mercy Philadelphia Hospitals.