Definition & Overview
Prostate cancer is one of the most common types of cancer that affect men aged 50 and above. A part of the male reproductive system, the prostate is a walnut-shaped gland that produces seminal fluids that nourishes and transports sperm as well as neutralizes the acidity of the vaginal tract. Located beneath the bladder, the prostate also contains smooth muscles, which main function is to expel the semen during ejaculation.
Prostate cancer develops due to inherited and acquired DNA mutations. Patients with a history of cancer in their family and who are at least 50 years old are at a higher risk of developing the condition. Other risk factors are a diet that consists of meat cooked at high temperatures, exposure to metal cadmium, and sedentary lifestyle.
There are different types and stages of prostate cancer. While some cases require no treatment, other types can grow more aggressively. Just like other types of cancer, early detection improves prognosis or the chances of curing the disease. For this reason, prostate cancer screening is highly recommended particularly to those who are considered at high risk of developing the condition.
Who Should Undergo & Expected Results
Cancer screening tests — including the prostate-specific antigen (PSA) is recommended for:
Men who are at least 50 years old – The American Urological Association recommends undergoing PSA starting at the age of 50. Depending on the risk factors of the patient, the screening test should be performed at a regular interval. However, it’s no longer necessary for men who are 75 years and older.
Race – studies have confirmed that black men have a higher risk of suffering and dying from prostate cancer.
Family history – patients who have a family history of prostate cancer have a higher risk of developing the condition.
Obesity and diet – patients whose diet includes meat that is cooked in high temperatures and who are obese are encouraged to undergo PSA.
Various organizations have different guidelines as to who should and shouldn’t undergo the test. However, the majority recommends the test for men in between the ages of 40 and 75 and those who have a family history of the condition. It’s also crucial for patients who are experiencing the following symptoms:
- Having a hard time urinating or urinating frequently particularly at night
- Having the feeling that the bladder is not empty following urination
- Having the sudden urge to urinate more frequently
- Having to strain to urinate
How Does the Procedure Work?
Prostate cancer screening is performed with prostate-specific antigen (PSA) blood test, which measures the level of PSA, a protein produced by cells of the prostate gland. Healthy men have PSA levels under 4 nanograms per milliliter of blood. If the PSA level goes above four, the chances of having a prostate cancer is 1 in 4. However, if the PSA is more than 10, the chances increase to more than 50%.
If the PSA level is more than four but the patient is not showing symptoms of prostate cancer, the diagnosing physician will perform additional tests, which include the following:
Transrectal ultrasound – Typically performed following an abnormal PSA blood test, this uses a small probe that is inserted into the rectum to assess the condition of the prostate. Using sound waves, the probe picks up the echoes produced during the procedure, which is used by the computer to create a black and white image of the prostate. The procedure can also be used to measure the size of the prostate gland and in conducting treatments including cryosurgery and brachytherapy.
Biopsy – If previous test results suggest the presence of prostate cancer, a biopsy will be performed. In this procedure, a sample of blood tissue will be taken through a core needle biopsy and assessed under a microscope. A thin, hollow needle will be inserted through the wall of the rectum into the prostate to remove samples. Due to the nature of the procedure, it is typically performed under local anaesthesia. The biopsy samples will then be assessed to rule out the presence or absence of cancer. If prostate cancer has been confirmed, the pathologist will determine the stage of cancer, which will determine the most appropriate treatment option.
Digital rectal exam – If prostate cancer has been confirmed, additional imaging tests will be performed to determine if cancer has already spread to different parts of the body. Imaging tests may use sound waves, x-rays, magnetic fields, and radioactive substances. A bone scan will also be performed.
Possible Complications and Risks
Experts have confirmed that prostate cancer screening has detected several cases of prostate cancers that would have never caused damage to the patient’s body. This type of diagnosis has led to some degree of overtreatment such as radical prostatectomy and radiation therapy, which are blamed for various side effects including urinary incontinence and erectile dysfunction. Meanwhile, prostatic biopsies are also associated with sepsis, positive urine cultures, hematuria, and pain as well as psychological effects particularly to those who have undergone biopsies but were later cleared of prostate cancer.
- Harris R, Lohr KN: Screening for prostate cancer: an update of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 137 (11): 917-29, 2002. [PUBMED Abstract]
- Litwin MS, Pasta DJ, Yu J, et al.: Urinary function and bother after radical prostatectomy or radiation for prostate cancer: a longitudinal, multivariate quality of life analysis from the Cancer of the Prostate Strategic Urologic Research Endeavor. J Urol 164 (6): 1973-7, 2000. [PUBMED Abstract]
- Steineck G, Helgesen F, Adolfsson J, et al.: Quality of life after radical prostatectomy or watchful waiting. N Engl J Med 347 (11): 790-6, 2002. [PUBMED Abstract]
- Fowler FJ Jr, Barry MJ, Walker-Corkery B, et al.: The impact of a suspicious prostate biopsy on patients’ psychological, socio-behavioral, and medical care outcomes. J Gen Intern Med 21 (7): 715-21, 2006. [PUBMED Abstract]
- Rietbergen JB, Kruger AE, Kranse R, et al.: Complications of transrectal ultrasound-guided systematic sextant biopsies of the prostate: evaluation of complication rates and risk factors within a population-based screening program. Urology 49 (6): 875-80, 1997. [PUBMED Abstract]
**What is Prostate Cancer Screening: Overview, Benefits, and Expected Results**
*Table of Contents:*
2. What is Prostate Cancer?
3. Why is Prostate Cancer Screening Important?
4. Types of Prostate Cancer Screening
- Digital Rectal Exam (DRE)
– Prostate-Specific Antigen (PSA) Test
– Transrectal Ultrasound (TRUS)
5. Prostate Cancer Screening Guidelines
– Age Recommendations
– Frequency Recommendations
6. Benefits of Prostate Cancer Screening
7. Expected Results of Prostate Cancer Screening
Prostate cancer is a prevalent and potentially deadly disease that affects men, particularly as they age. Early detection is crucial in successfully treating prostate cancer, making prostate cancer screening an essential tool in diagnosing and managing the disease. In this article, we will provide an overview of prostate cancer screening, its benefits, expected results, and explore the various methods available for detection.
**2. What is Prostate Cancer?**
Prostate cancer is a form of cancer that develops in the prostate gland, a small organ located just below the bladder in men. The prostate gland produces seminal fluid, which helps nourish and transport sperm. When abnormal cells in the prostate gland start to multiply and grow uncontrollably, it leads to the formation of a tumor. If left untreated, prostate cancer can spread to other parts of the body and become life-threatening.
**3. Why is Prostate Cancer Screening Important?**
Prostate cancer screening plays a vital role in detecting the disease at its early stages, often before symptoms become noticeable. Early detection significantly increases the chances of successful treatment and improves the overall prognosis for patients. Regular screening can help identify prostate cancer early, allowing physicians to implement appropriate treatment strategies promptly.
**4. Types of Prostate Cancer Screening**
There are several methods available for prostate cancer screening, each with its benefits and limitations. Let’s explore the three most commonly used screening methods:
– **Digital Rectal Exam (DRE):** During a DRE, a healthcare provider inserts a lubricated, gloved finger into the rectum to assess the prostate gland’s size, shape, and texture. While the DRE is a quick and relatively simple procedure, it can be uncomfortable for some individuals.
– **Prostate-Specific Antigen (PSA) Test:** The PSA test measures the level of PSA, a protein produced by the prostate gland, in the blood. An elevated PSA level may indicate the presence of prostate cancer. However, not all cases of elevated PSA are indicative of cancer, as other factors such as age, inflammation, or enlargement of the prostate can also cause increased PSA levels.
– **Transrectal Ultrasound (TRUS):** A transrectal ultrasound involves the use of a small probe inserted into the rectum to generate images of the prostate gland. This procedure helps healthcare professionals visualize the prostate and identify any abnormalities. TRUS is often used in conjunction with a biopsy to confirm the presence of cancer.
**5. Prostate Cancer Screening Guidelines**
Prostate cancer screening guidelines are established to provide recommendations on when and how often men should undergo screening. These guidelines take into account factors such as age, family history, and overall health. It is essential to consult with a healthcare professional to determine the most appropriate screening plan for individual circumstances. Here are some general recommendations:
– **Age Recommendations:** The American Cancer Society recommends that men discuss the potential benefits and risks of prostate cancer screening with their doctors starting at age 50 for average-risk individuals. For men at higher risk, such as those with a family history of the disease or African-American men, the discussion should take place at age 45. Men at a significantly higher risk, such as those with multiple family members affected by prostate cancer, may need to start the conversation as early as age 40.
– **Frequency Recommendations:** The frequency of prostate cancer screening varies based on individual risk factors. Generally, a screening interval of two to four years is recommended for average-risk individuals. High-risk individuals may need more frequent screenings, typically every one to two years, depending on the doctor’s recommendation.
**6. Benefits of Prostate Cancer Screening**
Prostate cancer screening offers several benefits, including:
– **Early Detection:** Regular screening can help detect prostate cancer in its early stages, when it is most treatable. Identifying the disease early increases the chances of successful treatment and improves overall survival rates.
– **Proactive Assessment of Risk:** By undergoing regular screening, individuals can stay informed about their risk of developing prostate cancer. This knowledge allows healthcare providers to tailor an appropriate screening and treatment plan.
– **Peace of Mind:** For many men, knowing that they are actively monitoring their prostate health through regular screening can provide peace of mind. Early detection can help alleviate anxiety about the potential development of prostate cancer.
– **Opportunity for Lifestyle Changes:** If prostate cancer is detected early, individuals have an opportunity to make lifestyle changes to reduce their risk factors. These lifestyle modifications may include adopting a healthier diet, increasing physical activity levels, and quitting smoking.
**7. Expected Results of Prostate Cancer Screening**
Prostate cancer screening can lead to different outcomes, depending on the individual’s specific circumstances. The expected results following screening may include:
– **Normal Results:** A normal screening result indicates that no abnormalities were detected during the screening period. However, it is important to note that a normal result does not completely rule out the possibility of developing prostate cancer in the future. Regular screenings are still necessary as a preventive measure.
– **Elevated PSA Levels:** An elevated PSA level does not necessarily signify the presence of prostate cancer but rather indicates the need for further evaluation. Elevated PSA levels may be caused by non-cancerous conditions such as inflammation or benign prostatic hyperplasia (BPH). Additional tests and examinations, such as a biopsy, may be necessary to determine the cause of the elevated PSA levels.
– **Abnormal Findings:** If screening results indicate the presence of abnormal prostate tissue or elevated PSA levels, further investigations, such as a biopsy, may be recommended. A biopsy involves removing small samples of prostate tissue for examination by a pathologist to confirm or rule out the presence of cancer cells.
Prostate cancer screening plays a crucial role in the early detection and effective management of prostate cancer. By identifying the disease in its early stages, individuals have a greater chance of successful treatment and improved long-term outcomes. Choosing the appropriate screening method and adhering to recommended guidelines based on individual risk factors are essential steps in maintaining prostate health. Regular screenings provide the opportunity for proactive assessment, allowing individuals to take control of their health and make informed decisions for their well-being. Remember to consult with a healthcare professional to determine the best approach for your specific situation and to discuss any concerns or questions you may have. Stay proactive, informed, and prioritize your prostate health for a healthier future.