What is prostate cancer?

For 2011, it is estimated that 233,000 men will be diagnosed with prostate cancer in the U.S.  Prostate cancer is the most common cancer diagnosed in men and is the second leading cause of cancer death in men.  In 2011, it is estimated 33,000 men will die from prostate cancer.

 “How do you beat prostate cancer?  Catch it early.  Get tested annually.  Just ask someone who didn’t.”  Jay Dee Allen, Jr,, Prostate Cancer Survivor

 WHO SHOULD BE SCREENED?

All men are at risk for developing prostate cancer but some have a greater risk than others.  The lifetime cumulative risk for developing prostate cancer in all men is 1 in 6.  African-American men have the highest incidence with a cumulative risk of 1 in 5.  Men who have  a family history of prostate cancer are at greater risk than the normal population for developing prostate cancer.

 PRIOR TO THE USE OF PSA TESTING THE 5-YEAR SURVIVAL FOR PROSTATE CANCER WAS ONLY 69%. THE 5-YEAR SURVIVAL RATE FOR PROSTATE CANCER NOW IS 99%!

PROSTATE CANCER RISK ASSESSMENT

A prostate cancer screening risk assessment identifies men who may be at risk for having prostate cancer. A risk assessment evaluates a man’s age, family history and race.  If it is deemed appropriate for a man to undergo a prostate cancer screening, the screening includes both a PSA blood test and a digital rectal exam.  If a man has an abnormal prostate on digital rectal exam and/or he has an elevated PSA then he may be at risk for having  prostate cancer.  The successful treatment of prostate cancer depends in large part on the cancer being diagnosed at an early stage. 

 Screening does not diagnose prostate cancer. Prostate cancer is diagnosed by a procedure known as a prostate biopsy.

PROSTATE-SPECIFIC ANTIGEN (PSA)

PSA is an enzyme that circulates in the blood in men. The PSA may be elevated for several reasons, including enlargement, inflammation, infection, or  prostate cancer.  The PSA is not a perfect screening test but it is the best test we have at this time for detecting a patient’s risk for prostate cancer.  It is possible to have a normal PSA when prostate cancer is present and it is possible to have an elevated PSA without cancer being present. 

DIGITAL RECTAL EXAMINATION (DRE)

A DRE is performed by a physician by inserting a lubricated gloved finger into the rectum to palpate the prostate.  The physician checks for nodules or irregular prostate size or shape.  

SCREENING RECOMMENDATIONS

Beginning at AGE 40 all men should consider having their first digital rectal exam and PSA test.  Depending on their risk group and the results of the initial PSA value, a PSA and digital rectal exam may need to be performed annually . Men should discuss prostate cancer screening with their physician.  If a man participates in a free community screening he should report those results to his primary care doctor for interpretation and follow up.  A man should consider his current health, his family and the medical facts when deciding whether to be screened.

MEN 50 AND OLDER

All men 50 and older should have a PSA and digital rectal exam with their annual physical if they have at least a 10 year life expectancy.