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WHO SHOULD GET TESTED FOR PROSTATE CANCER?
By: Justin Quock, M.D.


 

Prostate cancer is a very common and deadly cancer in men in the United States.

Who gets prostate cancer?

Only men and usually later in life, 40s and 50s often choose to be screened regularly for prostate cancer.

How do I know if I have prostate cancer?

There are three tests. The Prostate-Specific Antigen test (PSA test) is often done on a sample of your blood. The doctor can also physically check the prostate gland during a visit. If prostate cancer is suspected the doctor remove a small piece of the gland for testing.

Does a high PSA test mean that I have cancer?

Not always. Men who have prostate cancer may also have normal PSA levels.

When should I begin screening for prostate cancer?

When you begin testing depends on your individual risks of developing cancer. Men are at a higher risk for prostate cancer if

  1. You are older. Men younger than 40 rarely get prostate cancer and most cases are found in men over 65 years of age.
  2. You are African-American. Prostate cancer occurs more often in African-American men than in men of all other races.
  3. Having a family member or family members who have had prostate cancer increases the likelihood of developing the disease.

The American Cancer Society suggests men should talk to a doctor at age 50 about the pros and cons of testing to make the right choice for them. If you have a father or brother who had prostate cancer before age 65, then you should talk with your doctor at age 45.

The American Urological Association recommends getting your first PSA test and physical examination of the prostate at age 40 and then discussing with your doctor how often to get screened.

The American College of Physicians recommends that if you wish to be screened, PSA testing should begin between 50 and 69 years of age.

What are the risks of screening for prostate cancer?

When the doctor performs a biopsy there may be side effects to the procedure such as pain, bleeding, and sometimes infections. Some tumors found through PSA testing may grow so slowly or are so small that they are not threatening a man’s life. Detecting tumors that are not life-threatening is called "overdiagnosis", and treating these tumors is called "overtreatment."

Overtreatment can lead to unnecessary complications and harmful side effects including the inability to control urine flow, problems with bowel function, loss of erections or having erections that are inadequate for sexual intercourse, and infection caused by surgery and radiation therapy.

Testing may also cause unneeded anxiety or stress when waiting for test results.

What are the benefits of screening for prostate cancer?

To discover fast-growing tumors or cancer that requires aggressive treatment can be life-saving.

Discuss your risk of developing prostate cancer with your doctor when deciding how often you should get tested.

Medicare provides coverage for an annual PSA test for all Medicare-eligible men age 50 and older. Many private insurers cover PSA screening as well.


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