The prostate is a gland that sits below the bladder and wraps around the urethra [yoo-REE-thruh], a tube that transports urine out of the body. The prostate also produces semen. Prostate cancer is the most common cancer among men, but it is slow growing and usually highly curable. Prostate cancers have a 99% 5-year survival rate.
Prostate [PROS-teyt] screening is a series of tests that may provide early detection of prostate cancer. Currently, prostate screening has not been shown to improve outcomes or survival for prostate cancer, and further research is needed to determine if the tests are effective. Your doctor might still recommend this test, especially if you are part of a group that is at a higher risk for getting prostate cancer.
Because there are no standard tests for prostate cancer, it’s difficult to assess the risks. Currently, the two tests that are most often used in screening for prostate cancer have been shown to have the following problems:
- Screening may not improve outcomes for prostate cancer.
- Sometimes the tests are wrong.
- Further study and follow-up are needed to determine best practices for prostate cancer screening.
Beyond some mild discomfort, there are no long-term side effects of the two tests most commonly used for prostate screening, blood tests and digital rectal exams.
As with most cancers, it is easier to treat prostate cancer if it’s found early, before it has grown or spread to other parts of your body. Prostate cancer detected early enough has a good prognosis and in some cases, may not require treatment.
While there is no agreement about standards for prostate screening and no government recommendations, the American Cancer Society recommends regular screening tests for those with high risk due to genetic or lifestyle factors.
Prostate screening can be done as part of a routine medical exam. You may be asked to disrobe privately and put on a gown to allow your doctor access to conduct the exam.
Prostate screening has an initial testing phase involving a digital rectal exam and in some cases, blood tests to screen for PSA (prostate specific antigens [an-ti-juh ns]), which are substances in your blood that can be a sign of prostate cancer.
The digital rectal exam involves your doctor or healthcare provider inserting a glove-covered finger into the rectum to feel the prostate for abnormalities. If your doctor has concerns either because of the blood tests or the digital rectal exam, you may be asked to undergo the following additional tests:
- Prostate ultrasound or MRI
- Prostate biopsy [BY-op-see]
Depending on your age and other risk factors, these tests might not be needed, so talk with your doctor about next steps in your prostrate screening process.
If your initial exam or bloodwork reveals concerns, your doctor may recommend some additional follow-up and testing. You should be aware of the results of the digital rectal exam immediately. If your doctor recommended a blood test, those results may take several days.
If prostate cancer is detected, your doctor will work with you and, in some cases, an oncologist [on-CALL-oh-jist] to develop a treatment plan. Sometimes, doctors recommend active monitoring of prostate cancer which means that treatment is delayed and the cancer is closely watched. If you’re young and in good health, your doctor may recommend more aggressive treatment to provide better outcomes for your prostate cancer.
If you do not have signs of prostate cancer, your doctor may recommend some lifestyle changes to lower your risk, including a healthy, low-fat diet, exercise, and maintaining a healthy weight. Occasionally, men with a very high risk of prostate cancer may be advised to take preventive medicine.