Prostate Cancer Screening: What You Need to Know

By Amit Bhalodia, DO, Virtua Primary Care – Camden

Prostate cancer is the second-most common type of cancer in American men. While prostate cancer is a serious disease, it spreads slowly and most men diagnosed don’t die from it. This leaves some men asking their doctors whether the benefits of prostate cancer screening outweigh any downsides.

Here’s information you can use to have a productive talk with your doctor.

When Should I Talk to My Doctor?
The American Cancer Society recommends prostate screening for men:

• Age 50 who are at average risk and are expected to live at least 10 more years
• Age 45 who are at high risk of developing prostate cancer. This includes African Americans and men who have a first-degree relative (father or brother) diagnosed with prostate cancer at an early age (younger than age 65)
• Age 40 who are at even higher risk of developing prostate cancer (those with more than one first-degree relative who had prostate cancer at an early age)

PSA: Measuring a Protein in Your Blood
There are two parts to a prostate screening. A prostate-specific antigen (PSA) test measures the amount of the PSA protein in your blood. PSA is produced by both cancerous and noncancerous prostate tissue. Cancerous cells usually make more PSA than benign ones. 

Men without prostate cancer have a PSA level under 4 nanograms per milliliter (ng/mL). Men with a PSA between 4 and 10 ng/ML have a 25 percent chance of having prostate cancer. If your PSA is greater than 10, your chance increases to 50 percent.

However, a PSA is not foolproof. Factors that can raise your PSA include:

• Having an enlarged prostate, a condition called benign prostate hyperplasia (BPH)
• Being older, as PSA levels increase normally as we age
• Having prostatitis, an infection or inflammation of the prostate gland
• Some medicines, such as testosterone

Factors that might lower your PSA include:

• Medicines to treat BPH or other urinary symptoms
• Long-term use of aspirin, statins to treat high cholesterol, and diuretics

Feeling for Abnormalities
Since a PSA can produce “false-positive” and “false-negative” results, we also perform a digital rectal exam. During the exam, your doctor inserts a gloved, lubricated finger into your rectum to feel for any bumps or hard areas on your prostate that might be cancer. While the test is uncomfortable, it’s quick and usually isn’t painful.

If your PSA and digital rectal exam make your doctor suspect cancer, he or she may order additional tests, such as a prostate biopsy, to confirm your diagnosis. Your doctor also will weigh your age, the size of your prostate, and how quickly your PSA levels are changing when deciding next steps.

By discussing the screening and your risk factors for developing prostate cancer, you and your doctor can make the best decision for your overall health. 

Advanced Options for Prostate Care
Virtua Health offers advanced treatment options like robot-assisted surgery, and personalized support services for men diagnosed with prostate cancer. Individualized treatment plans based on your age, overall health, and other factors aim to get you back to the activities you enjoy. Click here to learn more. 

Updated December 18, 2020