Should I be screened for prostate cancer? 

 

The prostate gland is a gland that secretes certain types of fluids in men. It is located at the base of the urinary bladder and as a man gets older there is an increased rate cancer development in the gland. In fact, prostate cancer is the second leading cause of cancer-related deaths in America. That being said, many men with prostate cancer die from other non-cancer related causes like heart disease. 

 

Over recent years testing for prostate cancer has been done with a blood test called Prostate-Specific Antigen (PSA).When the results from the PSA were elevated, a referral to urology was made who would likely perform a series of biopsies which were painful and had side effects. The lesson learned from experience was that the PSA was elevated in a lot of men who did not have prostate cancer – though it was also elevated in most mean who did have prostate cancer. 

 

Because of the large number of false-positive PSA results, there has been a debate in the medical community over who should get screened for prostate cancer by testing the blood for PSA. The debate is still ongoing. Some of the larger medical groups recommend against PSA testing because of the high false-positive rate. 

Still, other groups like the American Urology Association (AUA) recommend for PSA screening as long as there has been a discussion with the patient regarding the pros and cons of testing. They recognize the high false-positive rate but have other ways of determining who would benefit most from biopsies such as monitoring how fast the PSA is rising, instead of just looking at a certain cut-off number. 

 

So the question of whether prostate screening is right for you is similar to many other questions in medicine, because the answer is not the same for everyone. Your doctor can help you figure out what is best for you. Hopefully in the future there will be a better way of testing for prostate cancer, but until then we must wrestle with the PSA. 

 

Dr. Dustin Gentry is a Family Medicine physician at Winston Medical Center. He has an active clinic and hospital practice at WMC and is available for all your healthcare needs. You can schedule an appointment today by calling 773-3503.