Prostate Cancer Screening
Article updated and reviewed by Larry A. Weinrauch, MD, Assistant Professor of Medicine, Harvard Medical School. Editorial review provided by VeriMed Healthcare Network on May 10, 2005.
The goal of screening for prostate cancer is to detect and effectively treat those cancers most likely to cause morbidity or mortality if left untreated. (Also see Health Profile: Prostate Cancer)
Prostate cancer is the most common cancer in American men and the second leading cause of male cancer death. The incidence of prostate cancer increases with age. Fortunately, prostate cancer is relatively uncommon before age 50 and death from prostate cancer is uncommon before age 60. Wider application of detection techniques (transrectal ultrasound and PSA (prostate-specific antigen) testing) has led to reports of a higher incidence of prostate cancer. Whether screening for prostate cancer and early treatment will result in a decrease in yearly mortality rates due to the disease is the subject of debate.
While there is debate over whether prostate screening should be done, what techniques could be used and what treatments work best, it does seem clear that all men over the age of 50 (and therefore at risk of prostate cancer) should have a periodic physical examination. Most physicians recommend digital rectal examination (DRE) which can detect both benign and malignant conditions in the prostate and rectum. Screening blood tests such as PSA and others can be useful. Unfortunately, elevated levels do occur in patients without prostate cancer, and sometimes low levels can be falsely reassuring. For this reason, when a diagnosis is in doubt, physicians resort to transrectal ultrasound and biopsy in men who have a long life expectancy.
Having a father or brother with prostate cancer doubles the risk for a man. The risk of prostate cancer is higher in African Americans than in other groups.
Given my overall condition, if you did find a prostate cancer would you recommend something other than “watchful waiting”?
Do you recommend the PSA test?
How accurate are these tests?
Will an ultrasound and/or biopsy be recommended?