While it largely develops in older men, prostate cancer can happen at any age, and it’s the second cause of cancer death among men in the U.S. That may be a startling statistic, but the good news is that regular screenings can drastically impact prostate cancer treatment outcomes.
Because catching this slow-growing cancer when it’s most treatable is key, we’re here to answer basic questions to help guide you through your prostate cancer screening process.
What is a Prostate Cancer Screening?
Any cancer screening means looking for cancer before it causes symptoms. The goal of screening for prostate cancer is to find cancers that may be at high risk for spreading if left untreated, and to find them early before they spread.
When Should I Get Screened for Prostate Cancer?
Although the medical community agrees it’s a good idea, there really isn’t a hard and fast rule on when prostate cancer screenings should start, or which screening methods should be used. It’s ultimately up to you and your primary care physician to talk about your prostate cancer risk and to create a screening plan that’s right for you. If family history or other risk factors apply to your situation, it's even more important to address it with your physician if you have a high risk of prostate cancer.
Prostate cancer usually doesn’t cause noticeable symptoms, especially in the early stages. If you do experience any of these symptoms, talk with your doctor right away:
- Back pain
- Blood in your urine
- Changes in your urine flow or frequency, including urinary incontinence
- Pain while urinating
- Pelvic pain
If you’re not experiencing symptoms, talk with your provider about prostate cancer screenings between the ages of 50 and 55 when most insurance carriers start covering them, or if any of the following criteria apply to you:
- Age 40 for men at high risk (family history of prostate cancer, especially more than one close relative)
- Age 45 for other high-risk men (African American men or those with one close relative with prostate cancer)
- Age 50 for men at average risk
Why Should I Get Screened for Prostate Cancer?
Catching prostate cancer in its early stages can save your life. Prostate cancer is highly treatable, and most men survive when it’s caught quickly. Start having the conversation regarding prostate cancer screenings with your primary care physician today if you haven’t already.
How Does a Prostate Cancer Screening Work?
There are a few screening options available to help detect prostate cancer, including:
- Digital rectal exam (DRE): allows your doctor to check your prostate for lumps (polyps) or anything unusual
- Prostate-specific antigen (PSA) test: checks for an increased PSA level, which could be a sign of infection, inflammation or an enlarged prostate
- Prostate cancer gene 3 RNA test: measures the amount of PCA3 RNA in your urine
What is a Prostate-Specific Antigen (PSA) Test?
PSA is a specific protein made in the prostate — a gland that is part of the male reproductive and urinary systems.
This is a special type of prostate cancer screening test that measures the amount of PSA in the blood. PSA blood tests are used to:
- check for prostate cancer in men showing symptoms.
- possibly find early-stage prostate cancer in men not yet showing symptoms.
- monitor men who have/had prostate cancer to see if it has returned.
Your AdventHealth provider may suggest you have a PSA test based on your:
- Age — starting at age 50 for average-risk men, and age 45 for those at high risk
- Ethnicity — Black men are generally a higher risk for prostate cancer
- Genetics — if you have a family member who has had prostate cancer or you have certain genetic mutations
Other factors that might affect PSA levels
Normal PSA levels for men are determined by age:
- 0.-2.5 ng/mL for men under 50
- 0-4.0 ng/mL for men ages 50-59
- 0-5.0 ng/mL for men ages 60-69
- 0-6.0 ng/ml for men 70 and older
Although elevated PSA levels in the blood can be a sign of prostate cancer, there are other reasons why a man may have high PSA levels, such as:
- infection in the prostate
- enlarged prostate, medically known as benign prostatic hyperplasia (BPH)
- urinary tract infection
- inflammation of the prostate, called prostatitis
- recent prostate biopsy or surgery
- certain medications including nonsteroidal anti-inflammatory drugs (NSAIDs), testosterone, and statins
What Happens If Results Are Inconclusive From A PSA Test? Are There Other Tests?
If after taking a PSA test for prostate cancer screening, your results come back showing a high amount, your doctor will talk to you about why your levels might be elevated and what your options are for follow-up.
Normally, your doctor will recommend taking another PSA test, especially if you are not currently showing symptoms of prostate cancer.
Other tests sometimes used if your results show high levels of PSA, or if the PSA test results are inconclusive, include:
- a digital rectal exam (DRE)
- urine test to check for infection
- prostate MRI scan
- prostate biopsy
Is a Prostate Biopsy an Option?
If prostate cancer screenings show a potential problem with your prostate, then your doctor may recommend a prostate biopsy.
During this medical procedure, your doctor uses a needle to collect a small tissue sample from the prostate for further testing. There are two main types of prostate biopsy procedures:
- A transrectal biopsy uses an ultrasound probe inserted into the rectum that the doctor uses to guide the needle into the prostate.
- A transperineal biopsy is done by inserting the needle through a small cut made between the rectum and scrotum.
After the biopsy, your doctor will advise you to stick to light activities for one to two days and take an antibiotic to ward off any infection.
The prostate biopsy is then viewed under a microscope to look for any abnormalities and/or signs of cancer.
Schedule Your Prostate Screening Today
Learning more and talking to your doctor about prostate cancer will help you take charge of your health, from psa screenings to successful early detection of prostate cancer and treatment. To aid in the diagnosis of prostate cancer and general cancer prevention, ensure to make regular visits with your healthcare provider if you are in a high-risk category. To learn more about prostate cancer and screenings, schedule your appointment today for optimal prostate health.
