Prostate cancer is the most common cancer among men, and the second most deadly, after lung cancer. There are screening tests available that can help detect prostate cancer at early stages when the patient may not feel any signs or symptoms, but these tests cannot diagnose the disease. If one or more of these tests detect abnormalities, your doctor may recommend additional tests, but a biopsy is needed to diagnose prostate cancer.
When and if routine prostate cancer screening should start is something to discuss with your doctor. While there are multiple screening guidelines that have some minor differences, Karmanos and McLaren urologists and oncologists recommend having a conversation with your primary care provider to discuss if screening for prostate cancer is right for you. The decision to screen for prostate cancer is a very personal decision between a man and their doctor that considers a patient’s age, health and preferences. For men who decide to screen for prostate cancer, screening should typically begin:
- At 45-50 if you are at average risk.
- At 40 or 45 if you are high risk. This includes:
- African American men.
- Those who have a first-degree relative, such as a father, brother, or son who was diagnosed before age 65.
- Men with certain inherited cancer syndromes, such as BRCA1 and BRCA2, and other genes.
The most common prostate cancer screenings are:
- Prostate-specific antigen (PSA) test: This is a blood test that measures levels of PSA, a protein made by cells in the prostate gland. While normal prostate tissue makes PSA, prostate cancers make even more PSA. A high PSA blood test can be, but not always will be, associated with prostate cancer.
- Digital rectal exam (DRE): The doctor does a physical exam to detect abnormal lumps or hard areas that could be cancerous.
If one of these tests is abnormal, your doctor may recommend a referral to a urologist to discuss if a prostate biopsy is right for you. Additionally, some men will need to get other blood or urine tests or an MRI of the prostate to help decide the next steps. While these tests can help determine who might have prostate cancer, a biopsy of the prostate is currently the only way to determine who does have prostate cancer.
If prostate cancer is found, many prostate cancers grow slowly. For almost all men who have slow-growing prostate cancer, doctors will recommend observing their prostate, which is a strategy called active surveillance. For other men with higher-risk or more aggressive cancers, doctors will recommend treatment. Should treatment be warranted, Karmanos offers the best options available across the Karmanos Cancer Network, including:
- Brachytherapy radiation, which utilizes temporary or permanent implants to deliver radiation to the prostate.
- Cryotherapy. This is a technique where special needles are placed in the prostate to treat part or all of the prostate.
- External beam radiation therapy (EBRT), which uses radiation to treat prostate cancer.
- High-intensity focused ultrasound (HIFU) where ultrasound energy is used to treat part or all of the prostate.
- Proton therapy, a radiation oncology treatment that uses protons to precisely target and treat tumors.
- Robotic-assisted radical prostatectomy utilizing the Da Vinci™ platform, the standard of care for surgical removal of the prostate.
For patients with advanced or metastatic disease, Karmanos has expert oncologists specializing in hormone therapy, chemotherapy and immunotherapy. These experts also lead clinical trials, making new and emerging treatments available to Karmanos patients years before they are available to the general public.
To learn more about prostate cancer screening, visit karmanos.org/prostatefacts.
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