By Dr. David Samadi

Prostate cancer remains one of the most common types of cancer among men, and cases are expected to increase in the coming years. However, thanks to advances in medical research and early detection techniques, the prognosis for many of those diagnosed has improved. Early detection is crucial to ensuring effective treatment and management of this disease. Understanding the importance of screening, the types available, and when to start can empower men to take control of their health and save lives.

The importance of early detection

Detecting prostate cancer early is essential for several reasons:

Best prognosis: Prostate cancer that is detected early, before it has spread outside the prostate gland, is often more treatable. In its early stages, the cancer is usually localized, meaning it has not spread to other parts of the body, such as the lymph nodes or bones. When prostate cancer is contained within the prostate, the chances of beating it with the right treatment options are significantly higher.

More treatment options: When prostate cancer is diagnosed early, patients have access to more treatment options. These may include less invasive methods such as active surveillance, surgery or radiation therapy. However, in advanced stages of prostate cancer, more aggressive treatments may be required.

Higher survival rates: Statistics show that the five-year survival rate for localized prostate cancer is nearly 100%. Early detection allows for timely intervention, which significantly improves survival rates and quality of life.

Types of prostate cancer screening and diagnosis tests

There are several methods used to detect prostate cancer, each with its strengths and limitations:

Prostate Specific Antigen (PSA) Test: The PSA test is a screening tool that measures the level of prostate-specific antigen in the blood. Elevated PSA levels may indicate the presence of prostate cancer, although they may also be due to benign conditions such as prostatitis or an enlarged prostate. It is a standard initial screening test, but may require additional testing to confirm a diagnosis.

Digital Rectal Exam (EDR): During a digital rectal exam, a doctor inserts a gloved, lubricated finger into the rectum to feel the prostate for abnormalities. This exam can help detect physical changes in the prostate, such as lumps or irregularities, although it is less effective at detecting cancer compared to the PSA test.

Biopsy: If the PSA test or DRE suggests the possibility of cancer, a biopsy may be performed to confirm the diagnosis. During a biopsy, small samples of prostate tissue are removed and examined under a microscope for cancer cells. This is the definitive way to diagnose prostate cancer.

Magnetic Resonance Imaging (MRI) and Ultrasound: In some cases, imaging techniques such as MRI or transrectal ultrasound are used to get a more detailed view of the prostate and surrounding tissues. These tests can help assess the extent of the cancer and plan treatment.

Guidelines on when to start screening

Recommendations on when to initiate prostate cancer screening may vary by organization and individual risk factors. Here is an overview based on current recommendations:

Average risk: For men at average risk for prostate cancer (no family history and no symptoms), screening is recommended to begin at age 40. It is important to discuss the potential benefits and risks of prostate cancer screening with your doctor.

Higher risk: Men at higher risk, such as those with a family history of prostate cancer or African-American men, may need to start screening earlier. Guidelines suggest starting at least at age 40 for those with a strong family history or additional risk factors.

Ongoing discussion: Prostate cancer screening is not a one-time event. Men should have ongoing conversations with their doctor about their risk and whether continued screening is appropriate, based on their age, health, and personal risk factors.

Making the decision

Deciding whether to undergo prostate cancer screening involves weighing the potential benefits against the risks. While early detection can lead to effective treatments, it can also lead to false positives, overdiagnosis, and anxiety or unnecessary treatments. It is crucial for men to discuss their individual risk factors, family history, and preferences with their doctor to make the best decision for their health.

Conclusion

Prostate cancer screening is essential to effectively detecting and managing the disease. By understanding the importance of early detection, becoming familiar with available screening methods, and following guidelines tailored to your risk, you can take proactive steps to maintain the health of your prostate. Regular discussions with your doctor and staying informed about your health status are key to making empowered, informed decisions. Early detection could be the key to a healthier future.

Dr. David Samadi is Director of Men’s Health and Urologic Oncology at St. Francis Hospital on Long Island. He is a renowned board-certified urologic oncologist and successful robotic surgeon in New York City. He is considered one of the leading prostate surgeons in the United States, with extensive experience in the treatment of prostate cancer and robotic-assisted laparoscopic prostatectomy. Dr. Samadi is a medical contributor on NewsMax TV and the author of *The Ultimate MANual*, Dr. Samadi’s guide to men’s health and wellness, available on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at Robotic Oncology and Prostate Cancer 911.