The Pros of Prostate Screening

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LEXINGTON One in seven men will be diagnosed with prostate cancer during his lifetime, according to the American Cancer Society, making it the second most common cancer and second leading cause of cancer death in American men. However, as high as these rates seem, the good news is, the earlier the cancer is detected, the lower that death rate will be.

“Depending upon when detected, prostate cancer can be manageable, with high survival rates if caught within the first two stages of the disease,” said Andrew C. McGregor, MD, Lexington Clinic urologist and head of Lexington Clinic Urology. “In fact, in most cases of prostate cancer, if detected before the disease has spread beyond the prostate to distant areas of the body, the five-year survival rate is nearly 100 percent.”

Unfortunately prostate cancer, a disease that grows slowly and remains confined to the prostate, is not a disease that is easily detected by warning signs or symptoms. “Usually, there are no symptoms associated with early prostate cancer. However, as the disease progresses, certain symptoms can occur. These include problems urinating and a decrease in the force of urine, blood in the urine or semen, erectile dysfunction, pain in the pelvic region, specifically hips, back, chest, and other areas of the body, bone pain, and weakness or numbness in the legs or feet,” said K. Eric Ruby, MD, FACS, urologist with Commonwealth Urology – Somerset, a part of Lexington Clinic. “The surest way to detect prostate cancer is through screening or an exam.”

There are two ways to detect prostate cancer –either through a prostate-specific antigen (PSA) blood test and/or a digital rectal exam (DRE). If signs of the disease are detected through either of these two methods, a prostate biopsy is then conducted to confirm diagnosis.

Of the two screening methods, a PSA test is most commonly recommended. This test measures the level of PSA, a protein produced by cells of the prostate gland, in the patient’s blood. In men with prostate cancer, the test usually reveals elevated levels of the protein. As is often the case, this test is performed in conjunction with a DRE, in order to help confirm prostate cancer as opposed to some other condition.

Recent developments, however, have led to changes in the recommendations for who should be screened for prostate cancer via a PSA test, and how often they should be screened. “Until recently, it was recommended that men, ages 50 and older, be tested yearly for prostate cancer,” said Ruby. “The commonly accepted guidelines now, recommended by the American Cancer Society, are that men with an average risk of developing prostate cancer begin screening at age 50, men with a high risk should begin at age 45, and men with an even higher risk should begin at age 40.”

There are certain characteristics to determine a patient’s individual risk factors. These include older age, as the risk of developing the disease increases with age; ethnicity, as African-American males are more likely to develop prostate cancer, as well as develop a more aggressive or advanced cancer; a family history of prostate cancer, breast cancer, or genes that increase the risk of breast cancer (BRCA1 or BRCA2); and weight, as men who are obese may develop an advanced form of the disease.

McGregor agrees with these recommendations, and added that men who are beginning to reach the recommended ages for PSA testing should always consult with a physician first to determine which testing schedule is right for them. “A trained urologist who provides diagnosis and treatment of prostate cancer can accurately provide a patient with a testing schedule to fit his individual needs,” said McGregor. “The physician can evaluate the risk-level of developing prostate cancer for the said patient and determine a personalized screening schedule that best fits that patient’s needs.”

Equally important to discuss with patients, particularly younger patients, is ways they can reduce the risk of developing prostate cancer. These include consuming a low-fat diet high in fruits, vegetables, and whole grains, maintaining weight through a regular exercise schedule, and knowing what risk factors they currently have for developing prostate cancer later on in life.