June is Men’s Health Month and although we do not minimize awareness of key illnesses such as disease and diabetes, this is an excellent time to encourage awareness of one of the most important areas concerning men’s health: Prostate Cancer.
According to the American Cancer Society1, prostate cancer is the most common cancer among men (after skin cancer), but it can often be treated successfully. It is essential to know the facts about this disease including risk factors and screening information.
Below are recommendations and guidelines offered by the U.S. Preventive Services Task Force (USPSTF) and the Prostate Cancer Foundation (PCF).
Should I Be Screened?2
The question of screening is a personal and complex one. It is important for each man to talk with his doctor about whether prostate cancer screening is right for him.
There is no unanimous opinion within the medical community regarding the benefits of prostate cancer screening. Those who advocate regular screening believe that finding prostate cancer early offers men a better chance to cure the disease if your cancer warrants treatment. It also may inform you that you do not need your prostate cancer treated.
Those who recommend against regular screening note that, because most prostate cancers grow very slowly, the side effects of diagnosis (a prostate Biopsy) and treatment would likely outweigh any benefit that might be derived from detecting the cancer at a stage when it is unlikely to cause problems.
Screening and Biopsy
PSA screening may reveal results that prompt a doctor to recommend a biopsy. However, the result may create more confusion if the PSA is mildly elevated.
Discuss these individual tests with your doctor to make screening decisions that are best for you.
Better cancer-specific blood and urine based tests are on the horizon, as well as investigations into using imaging, such as MRI, to help screen and target the biopsy for prostate cancer. Regardless, the PSA test remains an important tool in the diagnostic process.
PSA testing is not a preventive service, and is an individual decision you should make with your doctor.
It should be noted that these recommendations apply to screening only, i.e. testing of healthy men without symptoms. Once the diagnosis of prostate cancer is confirmed by biopsy, PSA is still routinely recommended and used for risk-assessment and post-treatment monitoring.
What is PCF’s message for patients and clinicians?4
Every case is an individual one. It is important to talk directly with your doctor who is your best advisor and closest to your individual circumstance.
PCF supports a model of shared decision-making between patients and their health care providers. Men should discuss carefully with their doctors the harms, benefits, uncertainties and risks associated with prostate cancer screening and what kind of information a baseline PSA and digital rectal examination can offer. We encourage patients to know their risk factors such as race and family history and for primary care physicians to acknowledge that high-risk populations may warrant distinct prostate cancer detection policies and disease management.
1 American Cancer Society (ACS). (2017). Prostate Cancer. Retrieved from American Cancer Society.
2 Prostate Cancer Foundation (PCF). (2017). Prostate Cancer Early Detection and Screening. Retrieved from Protate Cancer Foundation: https://www.pcf.org/c/early-detection-and-screening
3 Prostate Cancer Foundation (PCF). (2017). Prostate Cancer FAQs. Retrieved from Prostate Cancer Foundation: https://www.pcf.org/faq_category/prostate-cancer-faqs
4 U.S. Preventive Services Task Force (USPSTF). (2017). USPSTF FAQs. Retrieved from Prostate Cancer Foundation (PCF): https://www.pcf.org/c/uspstf-faqs