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Prostate Cancer Screening and Diagnosis

Medically reviewed by Teresa Hagan Thomas PHD, BA, RN — By Tim Jewell on October 24, 2022Prostate cancer is a type of cancer that affects the prostate gland. This small gland is present in people with a penis. The prostate gland is responsible for providing fluids that help transport sperm out of the body during ejaculation. Prostate cancer is relatively common, with about 1.28 million new cases globally each year. Prostate cancer can be especially life threatening for people older than 75. But prostate cancer is usually treatable when caught early before cancerous cells have time to grow and spread to surrounding organs. Screening early and often to look for the warning signs of prostate cancer can help detect and treat even fast-growing, aggressive prostate cancer. Read on to learn how doctors detect prostate cancer, the pros and cons of screening, and what your next steps should be if you receive a diagnosis.

How do you screen for prostate cancer

Doctors commonly use two tests to screen for prostate cancer:

Prostate-specific antigen PSA test

The prostate-specific antigen (PSA) test looks for heightened levels of PSA in your blood. Your prostate gland makes PSA. There are always detectable levels of PSA in your blood, but higher levels may indicate cancerous tumors in the prostate. There’s no PSA level that doctors consider typical. Typical PSA levels can vary throughout your life. But a doctor will usually compare your levels to the traditional benchmark of 4.0 ng/mL to determine whether they’re high enough for concern. You will typically go to a laboratory facility to have your blood drawn for a PSA test. Here’s how it works:A doctor or lab technician will take blood out of your arm using a small needle. You might feel a quick, sharp sting when the needle goes in. They will cover the insertion site with a bandage.They will send the blood sample to a laboratory for analysis. Results may take up to 2 weeks, but they’re usually available in a few days.You will receive your results through your insurance provider’s website, or a doctor will ask you to visit for an appointment to review your results.

Digital rectal exam

A doctor performs a digital rectal exam (DRE) to feel for abnormalities in and around your prostate gland through the layer of skin between your rectum and prostate. Your prostate is usually smooth along its outer surfaces. Bumps or growths can indicate the presence of prostate cancer. Along with a PSA test, a doctor can help confirm a prostate cancer diagnosis by feeling for growths or tumors through the rectum. Here’s the process for a DRE:A doctor puts on a glove and lubricates the fingers of the glove.They insert a lubricated, gloved finger slowly and gently into your rectum. They move their finger around to feel for bulges, growths, or tissue that’s firmer than usual, or for tender areas.

Who should get screened for prostate cancer

The American Cancer Society recommends you consult with a healthcare professional about whether to screen for prostate cancer. This shared decision making will take into account your risk factors as well as the benefits and risks of screening. Here are some of the most common recommendations for prostate cancer screening:

You should be between 55 and 69 years old

People younger than 40 typically have a very low risk of prostate cancer. And people over 70 may experience more risks than benefits of prostate cancer treatment depending on how severe and widespread it is.

You should undergo screening every 2 years

If you don’t have any noticeable symptoms of prostate cancer, a doctor will usually recommend screening every 2 years. It may be more frequent if you have symptoms or a higher risk of prostate cancer.

You can start screening at 40 years old if you re at high risk

People with a close family member with prostate cancer, such as a parent or sibling, may need earlier screening. Research suggests African American men also have a higher risk of prostate cancer.

Symptoms of prostate cancer

Here are the most common symptoms of prostate cancer. Talk with a doctor as soon as possible if you notice several of these symptoms at once:peeing a lot more than usuala burning sensation when you peehaving trouble getting pee out at first when you try to goa weak stream or dribble when you peeblood in your urinepain when you get an erection or ejaculatenew, unexplained pains in your hips, back, or upper thighs

What are the pros and cons of screening for prostate cancer

Screening for prostate cancer can save lives. But it can also lead to unnecessary diagnoses or tests. For some people, tumors in the prostate grow so slowly, they will never cause symptoms. The Institute for Quality and Efficiency in Healthcare says that PSA testing prevents 3 out of 1,000 potential deaths from prostate cancer. But it also provides 60 out of 1,000 people with an unnecessary diagnosis. This is called overdiagnosis. Prostate cancer treatment can have serious side effects, such as urinary problems and erectile dysfunction. In the case of overdiagnosis, people who would not benefit from treatment could unnecessarily experience these side effects. A positive screening result also means more tests. Tests to confirm prostate cancer, like a needle biopsy, can be invasive, though minimally. A prostate biopsy can also cause side effects, like blood in your semen or an infection. Talk with a doctor about the pros and cons of screening. Depending on your level of risk, you can decide whether screening is the best path for you.

Pros of screening

A negative test can feel reassuring, especially if you’re at high risk.A doctor may find prostate cancer before you ever have symptoms.Detecting prostate cancer before it spreads can improve your outlook.

Cons of screening

A false-positive test (meaning it shows cancer but you don’t actually have cancer) can cause worry. Only about 1 in 4 people with a positive PSA test have a biopsy that shows prostate cancer.A false-negative test (meaning it does not detect cancer that is there) occurs in about 1 in 7 cases.Screening may find cancer that may never cause symptoms. This can lead to unnecessary tests or treatments.

How does a doctor confirm a prostate cancer diagnosis

A PSA test and DRE may not be enough to confirm that you have prostate cancer. If a doctor suspects that you may have prostate cancer, they may perform one of the following tests to confirm the diagnosis:

Biopsy

In a biopsy, doctors insert a small needle into your prostate gland through your skin surface. They will withdraw and remove a small amount of tissue through the needle. They then send the tissue to a lab to analyze and detect any cancerous cells.

Proctoscopy

Proctoscopy uses a small, lighted tube with a camera to check for cancer. A doctor inserts the scope into your rectum to view the area around your prostate. They may also take a biopsy through the proctoscope.

Sigmoidoscopy

Sigmoidoscopy uses a slightly different kind of small, lighted tube with a camera. A doctor inserts it through your anus and into your sigmoid colon to look for abnormalities. This part of your large intestine comes right before your rectum. It can show signs of prostate cancer as well as other tumors or polyps that grow in your colon.

Colonoscopy

If a doctor suspects your prostate cancer has spread or you have other gastrointestinal symptoms, they may perform a colonoscopy. To do this, they will insert a small, lighted tube through your anus to look for tumors, polyps, or other growths in your colon.

What can I expect after a diagnosis

If a doctor diagnoses prostate cancer, they will typically determine what stage your cancer is in and what treatment may be most effective.

Staging

Staging refers to how advanced your cancer is. Staging is measured from 1 to 4, with 1 meaning cancer is contained to the prostate and 4 meaning it has spread far beyond the prostate. Staging is based on the TNM system from the American Joint Committee on Cancer:Tumor: how big the tumor isNodes: how many surrounding lymph nodes are affectedMetastasis: how far the cancer has spread beyond the prostate A doctor will also consider how high your PSA levels are as well as your Gleason score. This score measures how likely prostate cancer cells are to spread to nearby areas.

Treatment

If a doctor detects your prostate cancer at an early stage, you may not need treatment right away. They may recommend you come back for regular screenings, biopsies, and blood tests to ensure tumors don’t grow or spread. This is called active surveillance. If your prostate cancer is at stage 2 or higher, here are some other possible treatment options:Radical prostatectomy: A surgeon removes your prostate gland.Cryosurgery: A doctor uses a probe to insert cold gases into your prostate. These gases destroy cancerous tissue.Transurethral resection of the prostate: A doctor inserts a thin scope into your penis and through your urethra. The scope contains a sharp tool the doctor uses to cut away cancerous tissue that may keep you from peeing.Radiation therapy: This method applies doses of radiation to your prostate to destroy cancerous tissue.Hormone therapy: You take medication to reduce how much testosterone or other androgens your body makes. This can help slow the growth of cancerous tissue in your prostate.Immunotherapy: Doctors remove immune cells from your body and expose them to proteins in cancerous prostate cells. The immune cells are now able to fight more effectively against prostate cancer. Your treatment team will then inject the immune cells back into your body.

What s the outlook for people with prostate cancer

Prostate cancer outlook is measured using the 5-year relative survival rate. This refers to how many people survive for 5 years after their diagnosis. The 5-year survival rates for people with prostate cancer depend on how far the cancer has spread:Localized: over 99% if cancer is only in the prostate glandRegional: over 99% if cancer is only in the prostate and immediately surrounding tissuesDistant: 31% if cancer has spread beyond the prostate Early and frequent screening may enable a doctor to detect prostate cancer before it spreads. A 2015 meta-analysis found that screening reduced the risk of death from prostate cancer by 49%.

Takeaway

Prostate cancer is common but is often treatable when found before it spreads and becomes hard to treat or remove. You can usually start prostate cancer screenings at 55 years old and continue screenings every 2 years until you’re 70. A doctor may recommend screenings as early as 40 years old if you’re at high risk for prostate cancer. Last medically reviewed on October 24, 2022

How we vetted this article

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.American Cancer Society recommendations for prostate cancer early detection. (2021).
cancer.org/cancer/prostate-cancer/detection-diagnosis-staging/acs-recommendations.htmlCatalona WJ. (2018). Prostate cancer screening.
ncbi.nlm.nih.gov/pmc/articles/PMC5935113/David MK, et al. (2022). Prostate specific antigen.
ncbi.nlm.nih.gov/books/NBK557495/Jain MA, et al. (2022). Prostate cancer screening.
ncbi.nlm.nih.gov/books/NBK556081/Localized prostate cancer: PSA tests for prostate cancer screening. (2020).
ncbi.nlm.nih.gov/books/NBK284938/Prostate cancer screening (PDQ®)–patient version. (2022).
cancer.gov/types/prostate/patient/prostate-screening-pdqProstate-specific antigen PSA test. (2022).
cancer.gov/types/prostate/psa-fact-sheetPSA testing. (2021).
nhs.uk/conditions/prostate-cancer/psa-testing/Rawla P. (2019). Epidemiology of prostate cancer.
ncbi.nlm.nih.gov/pmc/articles/PMC6497009/Survival rates for prostate cancer. (2022).
cancer.org/cancer/prostate-cancer/detection-diagnosis-staging/survival-rates.htmlvan den Bergh RCN, et al. (2015). Impact of early diagnosis of prostate cancer on survival outcomes.
pubmed.ncbi.nlm.nih.gov/28723424/Walter SD, et al. (2021). Estimating the rate of overdiagnosis with prostate cancer screening: Evidence from the Finnish component of the European Randomized Study of Screening for Prostate Cancer.
pubmed.ncbi.nlm.nih.gov/34313874/What are the benefits and harms of screening? (2022).
cdc.gov/cancer/prostate/basic_info/benefits-harms.htmWhat is screening for prostate cancer? (2022).
cdc.gov/cancer/prostate/basic_info/screening.htmOur experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Current Version Oct 24, 2022 By Tim Jewell Edited By A. L. Heywood Medically Reviewed By Teresa Hagan Thomas PHD, BA, RN Copy Edited By Sara Giusti Share this articleMedically reviewed by Teresa Hagan Thomas PHD, BA, RN — By Tim Jewell on October 24, 2022

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