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Screening for Prostate Cancer
Men with prostate cancer often don't know they have it. This is because men may live with prostate cancer for many years without developing any symptoms. Screening tests allow doctors to check for prostate cancer in men who have no symptoms.
You may have heard different opinions about whether you should be screened for prostate cancer. You may have questions about your chances of getting prostate cancer, the tests involved in prostate cancer screening, or how well the screening tests work. It is no wonder that you might be uncertain about the benefits of prostate cancer screening; even doctors do not agree about the need for screening, who should be screened, and how often.
How Common Is Prostate Cancer?
Prostate cancer is very common. In fact, in the United States, prostate cancer is the most commonly diagnosed cancer other than skin cancer. One in every five men in this country will develop prostate cancer before his death.
Prostate cancer tends to develop slowly. Most men live with prostate cancer for a long time without any problems or symptoms, and many never experience any problems at all. Men who do have symptoms often find them troublesome, and the symptoms sometimes interfere with their daily lives. Symptoms of prostate cancer include blood in the semen or urine, pain during ejaculation, and difficulty urinating.
Because prostate cancer usually grows slowly, most men with prostate cancer die of causes unrelated to their prostate cancer. This does not mean that prostate cancer is a harmless disease. Prostate cancer can cause troublesome symptoms and, most importantly, in some men the cancer spreads to other areas of the body and leads to death.
Survival rates following treatment are higher when the cancer does not spread outside the prostate. When the cancer is only in the prostate, or only in the area around the prostate, almost all men survive. When the cancer has spread throughout the body, about a third of men live for more than five years.
Who Gets Prostate Cancer?
Although it can't be predicted who will develop prostate cancer, there are several risk factors for the disease:
It is possible that there are other risk factors for prostate cancer, including a diet high in fat. More research is needed to understand all of the risk factors for prostate cancer.
Benign Prostatic Hyperplasia
- You are more likely to develop prostate cancer if you have a family history of the disease
- You are more likely to develop prostate cancer if you are African-American
- You are more likely to develop prostate cancer as you become older
Another disease that becomes more common as men age is benign prostatic hyperplasia (BPH). Some of the symptoms of BPH are similar to prostate cancer, but BPH is not caused by cancer. Rather, BPH is caused by the abnormal growth of benign (non-cancer) prostate cells. The prostate gland becomes enlarged and can push against the bladder and the urethra, causing problems with urination. No studies have shown a direct link between BPH and prostate cancer.
It is important to realize that urinary problems in older men are much more likely to be caused by BPH than by prostate cancer. If you are experiencing urinary problems, talk to your doctor.
What Types of Screening Tests Are Used for Prostate Cancer?
There are two main types of screening tests for prostate cancer, the digital rectal exam and measurement of prostate-specific antigen in the blood. Often, both screening tests are used together.
Digital rectal exam (DRE): For this test, the
doctor puts on gloves, lubricates one finger, and puts that finger
into the man's rectum. Because the prostate is located near the
rectum, the doctor is able to feel the prostate through the rectum
wall and check for any unusually hard or lumpy areas.
If any unusual areas are found during the DRE, the doctor will recommend further testing to determine the cause.
Prostate-specific antigen (PSA): Prostate-specific
antigen (PSA) is a protein made by cells in the prostate. Most
of the PSA made in the prostate leaves the body in semen, but
a small amount enters the bloodstream. For PSA screening, a blood
test is taken to measure levels of PSA in the blood. An elevated
level of PSA in the blood can mean that a man has prostate cancer.
BPH or an infection in the prostate can also raise PSA levels. Because of this, prostate cancer can't be diagnosed with the PSA test alone. Instead, PSA screening is used to determine if further testing is necessary.
If screening tests suggest that you might have prostate cancer, your doctor may recommend an ultrasound exam and/or a biopsy.
- During ultrasound, sound waves are used to create pictures of the prostate. Signs of cancer are sometimes visible in these images.
- During a biopsy, a small amount of prostate tissue is removed. The tissue is examined for the presence of any cancer cells.