The key to prostate cancer prevention is early screening. Thousands of prostate cancer deaths could be avoided with early detection. Catching the disease at an early stage before it has the chance to grow or spread across the body makes treatment far more successful.
As a urologist, I know it’s easy for me to say “get checked early!”
I know that in reality lots of us will put off prostate cancer prevention. In this article, I am going to tell you why you need to get screened in under five minutes.
What patients are at a greater risk of living with prostate cancer?
- Men who are over the age of 50
- Men who have a family history of prostate cancer
- Genetically, black African and Afro-Caribbean males are at higher risk
Why are so many cancer cases diagnosed late?
More often than not, cancer cases are diagnosed late because:
- There is a lack of awareness around the signs and symptoms of cancer.
- Most people don’t have the time to visit their doctor on a busy schedule.
- There are often delays in physicians referring a patient for further testing.
- Some people might delay because they’re worried about what the doctor might find or they don’t want to waste the doctor’s time.
Getting tested early is key to prostate cancer prevention...
The 5-year survival rate for most men with local or regional prostate cancer is nearly 100%. Early screening is absolutely necessary in increasing positive outcomes for patients.
There has been debate among health care workers about whether the benefits of prostate cancer prevention programme outweighs the potential risk of overdiagnosis and over treatment.
I will talk you through this discussion, including my thoughts as we continue on our discussion around PSA testing.
What is PSA?
PSA stands for prostate-specific antigen, a substance produced in the prostate. PSA levels are determined through a blood test and an elevation may suggest the presence of prostate cancer. The test is not, however, prostate cancer specific.
PSA (Prostate Specific Antigen) is a chemical that appears in a man’s bloodstream at higher levels when the prostate gland is enlarged or cancerous. Although not a definite diagnosis of prostate cancer, a higher than normal PSA level can be a significant sign that something is not quite right and further testing might be required. Men need to make an informed decision for themselves whether or not to have their PSA tested.
What is involved in prostate cancer screening?
It is essential that those who are thinking about prostate cancer screening are aware that the full screening involves a rectal examination by a physician who will evaluate the feel and texture of the prostate gland as well as a blood test that measures prostate specific antigen.
I often talk to my patients about the known limitations of PSA testing, particularly the fact that it is not cancer specific. As prostate cancer is the number two cancer killer of men, there is nothing wrong with having a PSA test if a patient is concerned, wants to be screened and understands the shortcomings of the test.
In sum, if you are thinking about attending prostate cancer screening, you must:
- Take a PSA test which will measure prostate specific antigen in the blood.
- Attend a rectal examination.
What are the limitations of PSA testing?
PSA screening is not a perfect test. It is relatively inaccurate and can lead to unnecessary biopsies. Out of all patients who have “abnormal” PSA test results, less than one-third will ultimately have prostate cancer. That means that if all men with abnormal PSA results have a prostate biopsy, at least two-thirds of them do not have cancer.
Variables, other than prostate cancer that may cause high PSA levels include:
- Enlargement of the prostate gland which often happens as a result of age.
- A urinary tract infection
- Recent sexual intercourse or ejaculation
- Family history
While high PSA in the blood is linked to cancer, a high reading does not offer a diagnosis. It simply indicates that further examination is necessary.
Who benefits most from PSA testing?
Under the American Urological Association guidelines, the greatest benefit of PSA testing appears to be for men between the ages of 55 and 69 years. Men are considered to be at higher risk if they have a family history of prostate cancer (father, grandfather, brother, uncle) or are black African and Afro-Caribbean.
PSA Screening Guidelines
The American Urology Association has established the following general guidelines for PSA screening for men:
- Under age 40 — PSA screening is not recommended.
- Ages 40-54 at average risk — Routine PSA screening is not recommended.
- Under age 55 at higher risk (family history or you are black African and Afro-Caribbean.) — The decision for screening should be individualized.
- Ages 55-69 — The greatest benefit of screening appears to be in this age group. Men are strongly urged to consider PSA screening in accordance with their values and preferences. For those who choose to be screened, routine screening every two years is preferable to annual screening.
- Ages 70-plus — Routine PSA screening is not recommended (some men age 70-plus who are in excellent health may benefit from prostate cancer screening , but this decision should be made on a case by case basis.)
- With a life expectancy of less than 10-15 years — Routine PSA screening is not recommended.
This simple home PSA test from LetsGetChecked can give you a good indication of the health of your prostate and can even be an early signal of cancer. Take a look at how this convenient and confidential service works:
For prostate cancer prevention, visit www.letsgetchecked.ie to order a home PSA test now.
Written by U.S. Medical Director, Dr. Robert Mordkin | Edited by Hannah Kingston