What Are Your Prostate Options?

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Written by: James Cauley, MD, urologist with Agnesian HealthCare

One of the most common questions I receive in my practice is from men asking how they can protect themselves against prostate cancer. And, it is one of the most important questions they can ask!

Prostate cancer in its early stages rarely produces any symptoms that are easily recognized. Frequent urination - particularly at night, difficulty urinating, pain while urinating or blood in the urine can be a sign of either prostate cancer or benign prostate enlargement - more often the latter. Symptoms, such as bone pain, usually occur only after the cancer has spread to other parts of the body and there is little chance of successful treatment.

A prostate specific antigen (PSA) screen is a blood test that measures the prostate specific antigen (PSA) levels in the blood. Antigens are any substances that evoke responses from a person's immune system. The prostate specific antigen levels can be elevated in the presence of prostate cancer.

However, it is important to understand that other benign prostate conditions may also elevate PSA, such as benign prostatic hyperplasia (BPH), which is noncancerous swelling of the prostate. The pros and cons of PSA screening should always be discussed with your healthcare provider before testing.

Here are some guidelines to consider for PSA screening.

If you’re under age 40, screening is generally not recommended since there is a very low prevalence of cancer at this age.

If you are between ages 40 and 54 and are of average risk, routine screening is likewise not recommended. If you have risk factors, such as being African American or having a father or brother diagnosed with prostate cancer, you may want to discuss the matter with your doctor.

If you are age 70 or over or have a life expectancy less than 10 to 15 years, screening is not recommended because cancers generally grow slowly.

If you are 55 to 69 years of age, on the other hand, you are in a high risk category and should carefully weigh the benefits and risks of screening.

For men who choose screening, PSA testing is recommended once every other year rather than annually.

Prostate is the most commonly diagnosed cancer in men, and some estimate that at least a third of all males age 50 and over will develop a cancer at some time in their lives.

Today, the option of watchful waiting is more often recommended and chosen. This involves regular monitoring with PSA tests, digital rectal examinations, imaging and biopsies to make sure the cancer hasn’t progressed.

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