About 218,000 men were diagnosed last year with prostate cancer, and about 27,000 men died from the disease, according to the U.S Department of Health and Human Services.
Although doctors continue to debate the best approach to detecting early-stage prostate cancer, men age 50 and older (or younger for those who are at risk) should be screened annually for prostate cancer, says Dr. Ira Hantman of the Urology Center at Mercy Medical Center.
Who should be screened for prostate cancer?
The general guidelines still are that men 50 and older should have both a PSA screening (blood test) and a ... rectal exam on a yearly basis. Those with a paternal family history have a higher risk and should be screened about five years earlier - at age 45. In addition, African-American men should be screened at 45 as well, as they also have higher risk. And all men beginning at age 40 should have a yearly ... rectal exam.
Who is at risk for prostate cancer?
Most prostate cancers occur in men older than 50. Again, men with a paternal family history of prostate cancer and African-Americans have a higher risk for prostate cancer.
What is the PSA screening blood test?
PSA (or prostate-specific antigen) is a protein produced by the prostate gland. The PSA can rise for many reasons - some of them are benign, but the most significant reason is prostate cancer.
Why is the PSA screening test controversial?
The problem with the PSA test is that it isn't as specific as we would like because the normal growth of the prostate (BPH) will also elevate the PSA, [creating] a potential for false positive tests and for possibly unnecessary biopsies. But it is the best test we have, and it does allow for the early diagnosis of prostate cancer.
Another part of the equation is that there are two types of prostate cancer. One is diagnosed in younger men and can metastasize and can kill. The other is found in men over 80; generally, that prostate cancer is slow-growing and usually doesn't metastasize. Unfortunately, we can't differentiate whether a young man's prostate cancer will be the more malignant type or not, and therefore all younger men diagnosed should be treated.
And you think that regular PSA screenings are worthwhile?
I look at the mortality numbers [how many men die annually of prostate cancer], and they are down significantly from 10 years ago, and the screenings are contributing to that decrease in numbers.
There are two parts of the screening: the PSA blood test and the ... rectal exam. Either one picks up a fair amount of the disease, but combined, they pick up the cancer at a great rate.
How is prostate cancer diagnosed?
Once someone has an elevated PSA, we do a biopsy with ultrasonic guidance. It actually gives us a visual depiction of the prostate and shows any abnormal areas so we can focus on those parts.
What are the symptoms of prostate cancer?
It is when there are no symptoms of prostate cancer that you want to catch it. (There are no symptoms in the early stages.) If we can catch men with such a low-level of cancer, it really leads to a much greater chance of a cure.
At a later stage, the symptoms include having difficulty urinating, blood in the urine, bone pain, back pain and things like that. But that is at a later stage.
Is prostate cancer considered curable?
Yes, but again, it comes back to screening. If it is caught at an early stage, then the chances of being cancer-free for 15 years - which is basically a cure - approaches 90 percent for localized prostate cancer.