Prostate Cancer Screenings: Early Detection Improves Outcomes

In the United States, 1 in 8 men will be diagnosed with prostate cancer in his lifetime. Despite the alarmingly high number of men who develop prostate cancer, there is good news: more than 80% of all prostate cancers are detected when the cancer is confined to the prostate or the region around it, making it highly treatable. In fact, the 5-year survival rate in the U.S. for men diagnosed with early-stage prostate cancer is greater than 99%.

However, that success rate doesn’t mean prostate cancer is never deadly. Every day, 94 men die from prostate cancer in the U.S., making it the second leading cause of cancer death among men in the country. The real tragedy in those numbers is how easy it is to screen for the disease.

The most common screening method is a simple blood test called prostate specific antigen (PSA).

PSA is a substance made by the prostate, which then becomes detectable in your blood. PSA levels tend to be higher in men who have prostate cancer. But because other factors can influence PSA levels, including age, benign prostate enlargement, and certain medications, it’s important to let your doctor interpret your PSA test results. If your levels are abnormal, your doctor may refer you to a urologist who may recommend other tests, including imaging or prostate biopsy. It’s important to note that the actual diagnosis of prostate cancer can only be made with a biopsy.

As for who should get a screening and when, the American Cancer Society recommends men discuss screening with their doctor at the following ages and risk levels:

Age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age)
Age 45 for men at high risk of developing prostate cancer. This includes African American men and men who have a first-degree relative (father or brother) diagnosed with prostate cancer at an early age (younger than age 65).
Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years

If no prostate cancer is found, the timing for future screenings will be determined by the findings of the PSA test:

Men who have a PSA level of less than 2.5 ng/mL may only need to be retested every 2 years.
Screening should be done yearly for men whose PSA level is 2.5 ng/mL or higher.

WHEN TO SEE A DOCTOR

In most cases, early prostate cancer has very few or no symptoms. When they do appear, they may include:

Problems urinating, including a slow or weak urinary stream, or the need to urinate more often
Blood in the urine or semen

Symptoms of more advanced prostate cancer can include those noted above and:

Trouble getting an erection (erectile dysfunction or ED)
Pain in the hips, back (spine), chest (ribs), or other areas, from cancer that has spread to the bones
Weakness or numbness in the legs or feet, or even loss of bladder or bowel control, from cancer in the spine pressing on the spinal cord
Weight loss
Feeling very tired

In many cases, these symptoms are caused by something other than prostate cancer. However, it’s still important to tell your health care provider about your symptoms so they can determine the cause and treat it.

Matthew Vernon, MD, is a radiation oncologist at the Dartmouth Regional Cancer Center at Southwestern Vermont Medical Center