Prostate Cancer Screening
Problems with the prostate (a gland in the male reproductive
system) become more common as a man ages. These problems include
prostate cancer, a common cancer in men. This cancer can often be cured
or controlled, especially if it is found and treated early. Screening
tests help detect prostate cancer before it causes any symptoms.
Cancer is an uncontrolled growth of abnormal cells. These cells
form in one area and can spread through the body. Prostate cancer
causes no symptoms in its early stages. In fact, urinary problems are
more likely to be symptoms of another condition.
Risk Factors for Prostate Cancer
The things that can increase a man’s chance of developing prostate cancer are called risk factors. These include:
Age. The risk of developing prostate cancer increases as you grow older.
Family history. If your father or brother has had prostate cancer, your risk of developing it is higher.
Race. African American men are more likely than
other men to develop prostate cancer. They are also more likely to die
of prostate cancer than other men with this disease.
Screening for Cancer
Screening for prostate cancer is done with a physical exam and
blood tests. These tests can help determine whether it is likely that
you have cancer. The American Urological Association recommends that men
with risk factors begin yearly screening at age 40. Men with no risk
factors are offered yearly screening at age 50.
|The DRE takes just a few seconds. |
Tests You May Have
Prostate cancer screening tests include the digital rectal exam
(DRE) and a lab test called the PSA test. If the DRE or PSA suggests
that cancer may be present, other tests are then done. These tests help
show whether a man has prostate cancer.
Medical History and DRE
During your medical exam:
Your healthcare provider will ask about your personal and
family medical history. He or she will also ask about any symptoms you
Your provider will ask about any medications you take, including herbs and supplements.
If you’re having problems with urination, your provider may order a urinalysis to check for a urinary tract infection.
Your provider will perform a DRE. This involves inserting a
lubricated gloved finger into the rectum. Because the prostate is next
to the rectum, many prostate abnormalities can be detected with this
The PSA Test
PSA (prostate specific antigen) is a protein produced by
prostate tissue. The PSA level is measured with a blood test. The result
helps assess the likelihood of prostate cancer. To screen for prostate
cancer, the PSA test is done once a year.
Evaluating the PSA
A high or rising PSA level suggests that prostate cancer may
have formed. A lower PSA level indicates that cancer is less likely. In
addition to the PSA level, your doctor may look at:
The ratio of free PSA (PSA that is not bound to a certain protein in the blood) to total PSA.
The PSA velocity (how fast the PSA level is rising).
The PSA density (the relation of the PSA level to the size of the prostate).
Factors That Affect PSA
Many factors can affect PSA levels. Some, such as age, BPH, and
prostate cancer, are ongoing. Others, such as prostatitis or recent
sexual activity, have only a temporary effect on PSA. Your healthcare
provider can explain how these factors may affect the timing of the PSA
test and your results.
Abnormalities found with DRE may not be tumors. And a high PSA
level doesn’t always mean cancer. More tests need to be done. After
looking at the results of your screening tests, your doctor may
recommend other tests.
This test involves taking tissue samples from the prostate.
With transrectal ultrasound (TRUS) as a guide, a thin needle is used to
remove samples. The tissue samples are then analyzed in a lab to check
whether there are cancer cells and, if so, how likely they are to grow
If cancer is found, imaging studies may be done to check for
its spread. Bone scans(x-rays) check whether cancer has spread to bones.
CT and MRI can detect tumors in bones and soft tissues.
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