Prostate Cancer Screening

Confusion over Prostate Cancer Screening
There is a lot of confusing information about prostate cancer screening today. Sometimes we hear that men shouldn’t be screened at all, and other times we hear that some men should be screened and others not, or that older men should never be screened. Sometimes friends or relatives who have had prostate cancer tell us that all men with prostate cancer should have total prostatectomy (total removal of the prostate surgically), or that some men with prostate cancer should have no treatment at all! What is the truth here?

Basic Facts
There are only two ways to screen for prostate cancer. One way is a blood test, the Prostate Specific Antigen (PSA), and the other is a Digital Rectal Exam (DRE), where the examiner feels the prostate with a finger in the rectum, checking for lumps which could mean cancer. Unfortunately both of these methods have a lot of false positives (suggesting cancer when it is really not cancer at all). This, then, subjects a person to a lot of worry, and potentially unnecessary testing and biopsies which are ultimately normal. Consequently some medical groups in our country recommend against universal screening of all men.

In general, prostate cancers occurring in younger men tend to be more aggressive (growing and spreading faster), whereas prostate cancer occurring in older men tends to be less aggressive (growing and spreading very slowly). So a younger man (perhaps age 40-60) who has a family history of males with prostate cancer, may benefit more from a prostate cancer screening than an older man (probably 70’s or 80’s) who has no prostate cancer in the family.

Another consideration is the relative health of a man. For instance, a 60 year old with many other diseases and chronic medical problems who is not likely to live more than 5-10 years may benefit less from a prostate cancer screening than a vigorous 75 year old with many family members who have lived well into their 90’s.

One more consideration is the different treatment modalities for prostate cancer. Not only is there total prostatectomy, but also radiation treatment with a highly focused external beam, or radiation by implanting little pellets directly into the prostate, or even slowing or stopping the cancer growth by using some powerful hormone injections. There are definite side effects to each of these treatment types.

The Best Advice for You
Because of all of the complex variables, this is a very important subject to discuss with your Primary Healthcare Provider. He or she knows you and your health best and can give you more information about the pros and cons of screening for prostate cancer, and which screening schedule may best fit you and your health. Stay Well with help from Your Primary Healthcare Provider.

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