The prostate is a gland in men located just below the bladder and in front of the rectum. Cancer of the prostate is a major public health threat. Annually, over 200,000 men are expected to be diagnosed with the disease and an estimated 25,000 men will die from it. Add to that the fact that one in every six men will get prostate cancer during his lifetime,¹ and you can clearly see why everyone should be aware of and educated about this potentially deadly disease.

How Is Prostate Cancer Detected and Diagnosed?
The American Cancer Society (ACS) has developed guidelines to help doctors detect prostate cancer during its early stages. The ACS has recently revised those guidelines to reflect new scientific literature. The guidelines recognize that prostate cancer screening including a digital rectal examination (DRE), and a test to measure prostate-specific antigen (PSA) in the blood should be offered yearly to the general male population 50 years of age and older.²

In addition, males at increased risk for developing prostate cancer, such as men with a first-degree relative (father, brother, or son) affected by the disease or those of African American descent should consider annual screenings beginning at age 45.² Men with even higher risk because they have several first-degree relatives who had prostate cancer at an early age may want to speak to their doctor about starting annual screenings at age 40.

There are some instances in which screening may not be recommended. Because prostate cancer can be a slow-growing cancer, a man with a less than 10-year life expectancy would likely die of some other illness and, therefore, is not likely to benefit from prostate cancer screenings and treatment.

For this reason, the new ACS guidelines include a statement for patients explaining the risks and benefits of prostate cancer screening.² These guidelines can be found on the Internet at www.cancer.org or by calling the American Cancer Society at 1-800-ACS-2345. You and your doctor can discuss the ACS guidelines together and determine if screening is right for you, and, if so, when you should begin.

What Does Prostate Cancer Screening Involve?
A basic prostate exam involves two simple steps. One is a DRE, in which the doctor inserts his gloved, lubricated finger into the rectum to feel for any abnormalities on the surface of the prostate. This exam takes only about five seconds to perform. The other step of the examination process is a PSA blood test (see below). Results of this test are usually available within 24 hours.

If both of these tests are normal, the patient only needs to be followed again at the next yearly interval or at the advice of his physician. If results of either exam are abnormal, additional tests will be needed.

About the PSA Blood Test
PSA is a protein made by the prostate gland. PSA is made by both normal and cancerous prostate cells and is found in the bloodstream. However, as prostate cancer grows, the amount of PSA in the blood usually increases because prostate cancer cells produce more PSA than normal cells. So a high level of PSA in the blood or a noticeable increase in PSA from one measurement to the next may mean that cancer is present in the prostate.

PSA blood levels that are only slightly elevated are termed borderline. PSA results falling in the borderline range do not necessarily indicate the presence of cancer. For example, certain noncancerous prostate conditions can cause an abnormal PSA measurement.

If a patient’s PSA measurement falls within the borderline range, but the DRE is normal, a doctor may choose to perform other types of tests or wait a few months and repeat the PSA test. If the PSA level is in the high range, a doctor will most likely perform additional tests and may suggest a biopsy, which involves the removal and examination of a small amount of prostate tissue.

Talk to your doctor to find out if screening is right for you. Of course, no web site can take the place of careful discussions with your doctor. Only your doctor can weigh the risks and benefits and determine what options are right for you.

Click here to find more information about prostate cancer screening.

This material was designed to promote prostate cancer awareness, encourage annual screenings, and familiarize you with some of the medical terminology and procedures related to prostate care. It is not a substitute for the expert advice and judgment of a doctor. Patients and their loved ones should discuss any decisions regarding prostate cancer screening and treatment with their physician.

References:

1. American Cancer Society. Cancer Facts & Figures; 2007. Atlanta: American Cancer Society; 2007.
2. American Cancer Society. Detailed Guide: Prostate Cancer. http://www.cancer.org/docroot/CRI/content/CRI_2_4_3X_ Can_prostate_cancer_be_found_early_36.asp?rnav=cri Accessed June 4, 2007