Prostate Cancer Screening – Yes or No

The Facts Are 

A simple blood test is highly effective in detecting the levels of prostate-specific antigen (PSA) in a man’s bloodstream.  Yet many physicians still suggest that the test is not 100% accurate and therefore not necessary. Few male patients will insist on it.  Often overlooked is the simple fact that many serious diseases including prostate cancer show no early physical symptoms when treatments can be most effective.

In a survey of approximately 1,174 U.S. males 18 years or older, the Cleveland Clinic found that 72 percent of men would rather do household chores, such as cleaning the bathroom or mowing the lawn, than go to the doctor.  Even those men who take their health more seriously, some 20 percent of men admit they have not been completely honest with their MD.

It’s important that men understand that a PSA test is not a test for prostate cancer.  Unless you visit a primary care physician on a routine basis, you will never know if you are experiencing a steady rise or have a highly elevated PSA level.

Are You At Risk?

 While the youngest man diagnosed with prostate cancer was in his late 20’s, advancing age remains the biggest – but not the only risk factor.  Men who have a relative with prostate cancer are twice as likely to develop the disease. The risk is higher if a family member had been diagnosed before age 65 or if you are African American.   More African American men also die from the disease due to inequalities in gaining access to insurance, health care and appropriate treatment/follow-up.  If you are an African American male, you are 73% more likely to develop prostate cancer vs. white males and almost 3 times more likely to die from the disease.

Other Risk Factors

 In addition to not visiting a primary care physician on a regular basis, other risk factors can include where you live, high fat consumption, high processed carbohydrate diet and lifestyle choices.  Men who are overweight are at greater risk of developing an aggressive form of prostate cancer.  Men can also have an increased risk if they have a strong family history of other cancers – such as breast cancer, colon cancer, pancreatic cancer or ovarian cancer – all suggesting the possibility that multiple genetic factors can contribute to the overall risk of developing prostate cancer.

Physician Is Correct

The PSA, test is not 100% accurate, yet significant progress has been made in the way doctors look at findings.  Detection protocols for identifying prostate cancer now go a long way to eliminate unnecessary testing and/or treatment.

While the following is not medical advice … here are a few thoughts to ponder:

  • Consider establishing a baseline– A baseline PSA test between the ages of 35 and 50 is highly effective in predicting the lifetime potential of developing prostate cancer. The test can often identify men at highest risk and those at lower risk.
  • Is cancer in your immediate family? – Again, if your father, grandfather, brother or son has been diagnosed with prostate cancer, you may be at greater risk for developing prostate cancer.  If your grandmother, mother or sister has been diagnosed with breast cancer, the same inherited gene mutation in BRCA 1 and 2 for breast cancer can also put you at risk for developing prostate cancer.
  • If you are concerned with blood tests, ask about a liquid biopsy– These are blood and urine-based tests currently in use depending on where you are located.Initial results from these tests now suggest that the new liquid biopsy may be substantially more accurate than a PSA test and may better identify higher grade cancers that need more aggressive treatment.
  • Smarter screening –On average, if a man’s PSA level is below 2 at age 60, chances are good that he is at a very low risk of developing incurable prostate cancer during his remaining lifetime.
  • Active surveillance– Men initially diagnosed with low-grade cancer (confirmed by a biopsy, MRI and/or genomic tests) may be able to avoid or delay treatment unless other signs suggest that the cancer is advancing.

Hopefully the suggestions outlined here can help men overcome the fears often associate with routine medical check-ups.

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