Prostate Tests to Detect Cancer Early
Prostate cancer is a very common type of cancer in men, second only to skin cancer in the number of men affected. Fortunately, it is also one of the most successfully treated cancers when it is detected and treated in its earliest stages. Men with local stage cancer, where cancer is confined to the prostate, or regional stage, where cancer has spread only to areas close to the gland, have a 5-year survival rate of 100 percent, according to the American Cancer Society. Cancers that have gone undiagnosed long enough to spread further have a five-year survival rate of just 29 percent, providing a clear picture of the importance of regular prostate cancer screening.
When should you get tested for prostate cancer?
If you are experiencing symptoms that could be related to prostate problems, getting screened for prostate cancer is wise. Symptoms that should prompt PSA testing include:
- Frequent urges to urinate
- Frequent nighttime urination
- Pain or burning during urination
- A weak or interrupted urine stream
- Urinary incontinence, leakage
- Painful ejaculation
- Blood in urine or semen
- Frequent stiffness or pain in the lower back, hips, pelvis or upper thighs
Measures the level of prostate-specific antigen (PSA) to evaluate prostate function in men age 40 and older
Measures the level of freely circulating prostate-specific antigen (PSA) to evaluate prostate function in men age 40 and older
Men with no symptoms should have routine PSA levels testing done once a year. For the average man, PSA prostate screening should begin at age 50, when a man's chances of developing prostate cancer begin to rise rapidly. For men at high risk, annual screening should be done beginning at age 40. Men with the following risk factors are considered high risk for the development of prostate cancer:
- Men with first degree relatives (fathers, sons and/or brothers) who have been diagnosed with prostate cancer are at higher than average risk for developing the disease. If those relatives developed prostate cancer before age 65, risk is even greater.
- Men of African-American heritage, since prostate cancer rates are higher among this ethnic group.
- Men who are 65 years of age or older, who account for about two of every three prostate cancer cases, according to the American Cancer Society.
How do you diagnose prostate cancer?
Prostate cancer is often first detected through prostate screening. The standard screening test is a blood test called a Prostate-Specific Antigen (PSA) test. This test measures levels of PSA in the blood stream, a protein produced by the prostate gland. High levels of PSA are often found in men who have developed prostate cancer. However, a high PSA level does not always mean cancer. Other conditions and factors that can increase PSA levels, include:
- Enlarged prostate – This condition, also called benign prostatic hyperplasia (BPH), is a non-cancerous enlargement of the gland. It is very common among men as they reach middle age and beyond, and often causes PSA levels to rise.
- Prostatitis – This is infection or inflammation of the prostate gland, which can cause an increase in PSA.
- Medications – Men who are prescribed male hormones, such as testosterone, or medications that increase testosterone levels may have elevated PSA levels triggered by these medications.
- Aging – PSA levels rise gradually as men grow older, even when no prostatitis, cancer or other prostate issues are present.
Given these other potential causes, a high result from PSA testing is just the first step in diagnosing prostate cancer. Men with high prostate PSA typically have further testing that may include a digital rectal exam, in which a doctor examines the gland for abnormalities via the rectum, a prostate biopsy, where a sample of prostate tissue is examined for signs of cancer, and medical imaging procedures.
What is a normal prostate reading?
According to MedlinePlus, what is considered a normal PSA level in men during a cancer screen varies according to age. Men in their 50s or younger should have PSA levels below 2.5 nanograms per milliliter (ng/ml) of blood. In older men, a PSA level of 4.0 ng/ml are considered to be normal.
According to the American Cancer Society, men with a prostate PSA level between 4 and 10 ng/ml have a 1 in 4 chance of having prostate cancer. In men with PSA levels of 10 ng/ml or more, the chances of having prostate cancer are more that 50 percent. Additionally, the American Cancer Society also notes that the level considered normal varies from one doctor to another, with some recommending further testing with PSA test results as low as 2.5 or 3 – a decision that is often influenced by a patient's personal risk factors, including age, race and family prostate cancer history.
What age should you have a prostate exam?
The term "prostate exam" generally refers to a digital rectal exam (DRE), which may be done in combination with a PSA test during cancer screenings or independently as a routine prostate health check. The DRE is a physical examination, done by your doctor, of the prostate gland. To perform this exam, your doctor will insert a gloved and lubricated finger into the rectum to feel for any changes or abnormalities in the prostate gland including enlargement, bumps, hard areas or texture changes that may indicate prostate conditions and/or prostate cancer.
Men of any age who have noticed any of the prostate-related symptoms listed above should see their doctor for a prostate exam immediately. Routine annual prostate exams, as part of standard preventive care, are recommended for all men 40 years of age or above, as risk of developing most prostate conditions begins to rise in men of this age group.
5-year survival rates: https://www.cancer.org/cancer/prostate-cancer/detection-diagnosis-stagin... Normal PSA readings: MedlinePlus: https://medlineplus.gov/ency/article/003346.htm American Cancer Society: https://www.cancer.org/cancer/prostate-cancer/detection-diagnosis-stagin... Risk factors: https://www.cancer.org/content/dam/cancer-org/cancer-control/en/booklets...