Commonly asked questions about prostate cancer screening

Pleas to undergo preventive cancer screenings can sound repetitive and, sometimes, even annoying. But the fact is, early diagnosis can raise the five-year survival rates for prostate cancer to nearly 100%.
 
Early detection can keep cancer localized in the prostate before it spreads to other parts of the body, such as bones, lymph nodes, liver and lungs.
In the U.S., prostate cancer is the most commonly diagnosed cancer among men besides skin cancer. It is the second most common cause of cancer-related deaths after lung cancer in men. Statistically, in a group of eight men, one of them is likely to be diagnosed with prostate cancer. That number is even smaller among Black men, where one in six is likely to be diagnosed.

How is prostate cancer detected?

The prostate is located below the bladder and in front of the rectum. Most prostate cancer grows slowly, so early screening can give patients a more promising prognosis.

A blood test called the prostate specific antigen (PSA) is the first line of screening for prostate cancer. High levels indicate a need for further testing. In addition, providers can determine if the prostate, which is normally the size of a walnut, is enlarged with a digital rectal exam (DRE).

Some conditions can lead to false positives on screening tests. These include an enlarged prostate or PSA levels that are elevated for other reasons. Since about 2010, doctors often recommended active surveillance where providers closely monitor prostate cancer to see if it grows before treating it, according to the Centers for Disease Control.

What are the symptoms of prostate cancer?

Like many types of cancer, some people experience no symptoms. That’s why early screening is so critical.

Those who have symptoms report:

• Urinary problems, either a slow or weak stream or the need to urinate more frequently, especially at night
• Blood in urine or semen
• Erectile dysfunction
• Pain and weakness in ribs, hips, back and other areas
• Numbness in legs/feet. May be accompanied by loss of bladder and bowel control.

Who should be screened for prostate cancer?

This can be different based on various factors. Your doctor will likely recommend earlier testing if you have a family history – a brother or father diagnosed with prostate cancer – or have other concerning risk factors.

Overall, prostate cancer screening is recommended at:

• Age 40 for Black men and those with first-degree relatives (father, son, brother) who have been diagnosed with prostate cancer at a young age – generally before 65.
• Age 45-60 for those with one first-degree family member diagnosed with prostate cancer before 65.
• Age 50 and older who are at average risk of developing prostate cancer, have no family history or personal risk factors, and are expected to live 10 years or more.

If you are over age 70, discuss the risk/benefit factor of undergoing prostate screening. Several organizations, including the CDC, American Academy of Family Physicians and American Urological Society, do not recommend routine screening at age 70 and older.

At this point, providers would consider the risks/benefits for a patient, including life expectancy, family history and past PSA results.

Can I control any risk factors?

Like many cancers, lifestyle and the condition of your overall health change risk factors for prostate cancer. Some factors are controllable, and some are not.

Risk factors you can change include diet, weight, smoking, second-hand smoke and exposure to sexually transmitted infections. Risk factors out of your control include age, family history and race.

Black men have a higher rate of prostate cancer and higher death rates from it. They are also more likely to be diagnosed at a younger age and with more aggressive cancer. Because of this, additional screening guidelines apply.

• Discussions about PSA screening should begin at age 40.
• Baseline testing should be done between age 40 and 45. Patients should follow up annually after that.

Research on prostate cancer treatment continues to offer promising solutions. Genetic research can narrow down which men are more likely to develop prostate cancer and which cancers are likely to spread. Improving the PSA tests and newer screening tests are also on the horizon, according to the American Cancer Society.

At Sentara, we provide services to support you during and after treatment for prostate cancer. We offer financial, scheduling and treatment help, and connect you to support groups.

Learn more about cancer support services

Find a cancer specialist or call 1-888-220-2214 to learn more.