Prostate Cancer: The Benefits of Screenings and Knowing Your Risk

By: Dr. Julio Davalos

If you are a man living in the United States, chances are you or someone you know has prostate cancer.

According to the American Cancer Society, one in seven men will get the disease in his lifetime. And this year alone, nearly 30,000 men are expected to die from it.

Prostate cancer screenings detect many cases early, allowing millions of men to live full, healthy lives.  But before scheduling a screening appointment, men should understand their risk for the disease, as well as the risks and benefits of screenings.

Prostate cancer affects the walnut-sized prostate gland located just below the bladder. In early stages, symptoms are almost nonexistent. As the cancer grows, men can experience problems passing urine, blood in the urine, trouble getting an erection, weakness or numbness in the legs or feet and pain in the hips, back and chest.
While the disease is rare in men younger than 40, the risk of getting prostate cancer rapidly rises after age 50. Other prostate cancer risk factors include:

• Diet – Studies show men who eat a lot of red meat or high-fat dairy products and fewer fruits and vegetables have a slightly higher chance of getting the disease.
• Family history – Having a father or brother with prostate cancer more than doubles a man’s risk of the disease.
• Obesity – Studies show men who are obese are more at risk.
• Race/ethnicity – African-American and Caribbean men of African ancestry are also more at risk.

Prostate screenings typically involve two parts: a blood test and a digital rectal exam.

The prostate gland produces prostate-specific antigen (PSA), a substance found mostly in semen and, in small amounts, blood. During a screening, medical professionals take blood samples from men to test for PSA. An increase in PSA level may detect prostate cancer. 
During the digital rectal exam, doctors examine the prostate, checking for bumps or hard areas that could indicate cancer. The test is quick, often performed in a minute or less.

Screening supporters say finding and treating prostate cancer early gives men more treatment options, possibly with fewer side effects. In addition, a normal PSA test can put men’s minds at ease. 
But PSA levels can be elevated, even when cancer does not exist. A normal PSA test can also miss some prostate cancers, according to the American Urological Association (AUA). And not all prostate cancers require treatment, as some are slow growing and never spread beyond the prostate gland.

In men without symptoms, the AUA says the greatest benefit of routine screening is for those ages 55 to 69.

That’s why it recommends men who are younger than 55 or older than 69 and are worried about their personal risk factors talk with their doctor about whether prostate cancer screenings are appropriate. 

Health care providers, including primary care physicians and urologists, can guide you through the process, helping you make a decision that’s right for you and your future.

-Dr. Julio Davalos is a urologist at the University of Maryland Baltimore Washington Medical Center and medical director of the kidney stone program at UM BWMC and Chesapeake Urology. To reach Dr. Davalos, please call 410-760-9400.