Detecting Prostate Cancer

Who should get a prostate cancer screening?

Current recommendations are, are that at the beginning age of 40, men should be screened with a prostate examination looking for prostate cancer. This also will uncover men who have colon cancer, and that's certainly another very common malignancy. By age 50, we believe that all men should have prostate cancer screening by examination, and we would also add a blood test at that point.

Why is early prostate cancer detection important?

Well, if we detect the prostate cancer early when it is confined to the prostate, then our chances of eliminating and curing the disease are much higher.

What are the symptoms of prostate cancer?

Early prostate cancer often has no symptoms or signs of any sort, such that regular screening is important to detect it. As the cancer progresses, it may present obstructive symptoms, meaning the man develops urinary complaints and difficulties.

What are some rare but dangerous symptoms of prostate cancer?

In some cases of a very advanced but otherwise undetected prostate cancer, symptoms related to that advanced disease may be apparent, such as complete urinary obstruction, spread of the cancer to the bones that may cause difficulty walking, or bone pain could be apparent.

How do lymph nodes play a role in testing for prostate cancer?

Prostate cancer, like other malignancies, tend to spread often first to adjacent lymph nodes. Therefore, detecting cancer in the lymph nodes may demonstrate whether there is in fact spread of the cancer.

What are the benefits of screening for prostate cancer?

We feel that we can have the greatest effect in eliminating or curing prostate cancer by early detection when it's small and confined to the prostate. Regular screening, which would include the prostate exam and, when appropriate, the blood test, give us the best chance of finding it at the earliest stages.

What should I consider before being screened for prostate cancer?

Urologists and other physicians feel that it's important to screen for prostate cancer, since it's such a common cancer and one that is highly curable if found early. The controversy in screening for prostate cancer is, if either the examination or the blood test suggests there is a risk for prostate cancer, this may then lead to further testing some of which may be considered invasive.

What does 'comparative risk' mean in prostate cancer?

Well, we look at prostate cancer as one of the most common malignancies in men, and one of the most common causes of cancer related deaths in men, and therefore an important cancer to screen for. The factors that would make us be more inclined to screen would be, for example, someone who has a family history of prostate cancer. Screening for other cancers when there are risk factors, such a lung cancer in a smoker, can be important, but prostate cancer is such a common disease we think it's important to screen for that disease.

What is an 'over diagnosis' in prostate cancer?

One of the controversies in screening for prostrate cancer is that with the blood test that we use, called the PSA, it may detect a small cancer that perhaps would never cause a problem for a given man in his lifetime. Therefore if we search out and discover prostate cancer in a large number of men, we may find cancers that in fact would never cause a problem for these men in their lifetime.