Early Screening and Detection of Prostate Cancer
Early screening and detection of prostate cancer can be life-saving. Prostate cancer is one of the most common cancers among men, and when caught in its early stages, the chances of successful treatment are significantly higher.
Regular screenings, including prostate-specific antigen (PSA) tests and digital rectal exams (DRE), can help identify the disease before symptoms develop, offering a critical window for early intervention.
Understanding the importance of these screenings and the options available is essential for men, especially those at higher risk due to age, family history, or other factors.
What is Prostate Cancer?
Prostate cancer occurs when cells in the prostate glands grow uncontrollably. The prostate, a walnut-sized gland in the male body located below the bladder and in front of the rectum, produces and stores the fluid that makes semen.
What Causes Prostate Cancer?
The exact cause of prostate cancer remains unclear, but several risk factors can increase your likelihood of developing it during your lifetime. These include having a family history of prostate, breast, or ovarian cancer, being an African American male, carrying the BRCA gene, and leading a lifestyle of poor diet habits and obesity.
How Can I Prevent Prostate Cancer?
There is no sure way to ensure you never develop prostate cancer in your lifetime, but there are specific lifestyle changes you can make to help reduce your risk, such as maintaining a healthy weight, eating a nutrient-rich diet, and exercising regularly. Talk to your doctor about an increased risk of prostate cancer, getting screened for prostate cancer, and if you have any symptoms such as difficulty urinating, blood in urine, blood in semen, erectile dysfunction, bone pain, or unintentional weight loss.
How Can Prostate Cancer Be Detected Early?
Prostate cancer can be detected early through two primary screening methods: the prostate-specific antigen (PSA) test and the digital rectal exam (DRE). The PSA test measures the level of prostate-specific antigen in the blood. PSA is a protein produced by the cells of the prostate. Because cancerous cells tend to produce more PSA, a spike in your PSA level may signify a problem. However, there are other benign conditions that may cause an uptick in PSA.If you’re having a PSA test, it can often be added on to other blood work you may be having that day, and you may not need a separate blood draw.
DRE involves a physical examination of the prostate to check for abnormalities. Your doctor will insert a gloved, lubricated finger into your rectum and press toward the front of your body to feel the prostate. A prostate that’s enlarged or irregularly shaped, or bigger than it was at your previous exam, is a red flag that should be investigated.
While imaging is not routinely used as a screening tool, MRIs can reduce unnecessary biopsies in patients with elevated PSA levels. MRIs aid in identifying significant cancers, guiding biopsies, and assessing the extent of the disease for treatment planning. Additionally, MRI is useful in monitoring low-risk prostate cancer during active surveillance and detecting recurrence after treatment.
When Should I be Screened for Prostate Cancer?
Prostate cancer screening recommendations vary widely according to different society guidelines and expert recommendations. In general, most groups agree that high risk individuals should start screening earlier and most men should at least discuss screening with their providers by the age of 50. The table below provides an overview of PSA screening guidelines highlighting the importance of discussing your options with your healthcare provider to determine the best approach for you.
Association (AUA) recommends that men under 40 should not be PSA screened, and men aged 45 years and older are encouraged to get a yearly DRE screening. The AUA recommends screening in men aged 40-45 only if they are at high risk for developing prostate cancer and for all men aged 45-69 to be PSA screened every 2-4 years. Men over 70 years of age or with a life expectancy of less than 10 years typically will not benefit from a PSA screening.
Talk to your doctor at your next checkup to go over your particular risk factors.