Establishing a routine schedule for prostate cancer screening is the best way to detect prostate cancer in its earliest stages—giving you the greatest chance of successful treatment.
First, talk to your doctor at your next checkup to go over your particular risk factors. You may have more than one risk factor at play and thus have a greater chance of developing prostate cancer than other men.
In general, discussions with your doctor about screening for prostate cancer should begin in your 40s. Here are some rough guidelines:
|Do you have family history of prostate,
ovarian, breast, colon, or pancreatic cancers,
or do you know that Lynch syndrome,
BRCA, or HER2 gene mutations are present in your family?
|Discuss screening with your doctor starting
around age 40.
|Are you African American?||Discuss screening with your doctor starting
around age 40.
|How old are you?||In the absence of other risk factors,
discuss screening with your doctor starting at around
Learn more about how your age, race, and other factors may affect your prostate cancer risk.
Routine screening usually includes two simple tests: the PSA and the DRE.
The PSA test measures levels of prostate-specific antigen in the blood. In most cases your doctor will add this test in with other routine blood work at your regular checkup. 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 usually signifies a problem, however, there are other benign conditions that may cause an uptick in PSA . Tracking your PSA over time is a very valuable metric, because some cases of prostate cancer are so slow-growing that they don’t even need to be treated. However, even if your level is still within normal range, but is higher than it was the last time it was checked, it’s worth checking further.
What happens next?
Subsequent to PSA screening, depending on your results, your doctor may recommend follow-up tests and/or a biopsy. There are many other supplementary tests and considerations that can help you and your doctor decide if a biopsy is necessary, including:
- Digital rectam exam results
- The percent free PSA test (Less than 10% increases risk of having cancer)
- PSA velocity or the rate of rise over time (faster increases risk of having cancer)
- PSA density = PSA per volume of prostate (higher density increases risk of having cancer)
- PSA-based markers (ed, Prostate Health Index, 4K score)
- Other markers, eg, urinary PCA3 or Select MDx text
The other routine test for prostate cancer is the DRE, or digital rectal exam. YYour 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.
Are there any other tests I should have as part of my screening routine?
Better cancer-specific blood- and urine-based tests are on the horizon, as well as options for using imaging, such as MRI, to help screen and target the biopsy for prostate cancer. Regardless, they do not replace the PSA test as an important tool in the screening process.
How is the PSA used after diagnosis?
PSA is a very useful tool for screening—that is, testing of healthy men without symptoms. Once the diagnosis of prostate cancer is confirmed by biopsy, PSA is also routinely recommended and used for risk-assessment and post-treatment monitoring. Your doctor will use the PSA as one of many guides to indicate whether treatment is working and, down the line, whether the cancer recurs.
Learn more about how prostate cancer is diagnosed.
Are You at Risk for Prostate Cancer?
Take this quiz to find out when you should start screening.
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