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Prostate Cancer Screening

Prostate Cancer Screening

Prostate Cancer Screening

The good news is that if Prostate cancer is detected early and treated, there is a 90% success rate among patients. 

Prostate cancer is the second leading cancer diagnosed in men. It is also ranked sixth for male cancer fatalities globally.

Prostate cancers can be divided into two categories those that are slow-growing and those that grow rapidly and are alarmingly aggressive in nature.

Prostate cancer can metastasize (spread) to the lymph node, colon, bladder, and bones. Unfortunately, once it has reached this stage, treatment is exponentially more difficult. This is why screening is so important. Screening reveals cancer before symptoms appear so that you can get a head start on treatment.

What does Prostate Cancer Screening entail?

Prostate cancer screening is done by administering a PSA blood test. PSA is the acronym for prostate-specific antigen. This protein is secreted from the prostate gland cells. If your prostate is healthy it will be present in normal amounts. However, elevated levels may be an indication of prostate cancer. However, certain benign conditions like prostatic hyperplasia (BPH) and prostatitis may also cause high PSA levels.

The reason why Prostate Cancer Screening is important is that treatment is likely to be more effective in the early stages.

However, screening is not customarily recommended for all men and guidelines may differ slightly because not all prostate cancers require treatment. Your age and any existing comorbidities may determine your eligibility for treatment. Testing in these circumstances may simply result in undue stress and anxiety.

Prostate Cancer Screening Services

1. PSA Testing

Most medical regulations advise that men between the ages of 50-70 should have regular PSA tests. However, younger men can be screen if certain risk factors are revealed in their medical history. The following factors may increase your risk of developing prostate cancer:

  • Family history of prostate cancer
  • Infections (particularly STI’s like gonorrhea, chlamydia, and syphilis)
  • Past exposure to certain herbicides and toxins (e.g. Agent Orange)
  • Predominantly sedentary lifestyle and lack of exercise.

2. Free PSA Testing

Another Prostate screening test that is also used is the Free PSA test. To understand how this test works you have to know a bit about PSAs. PSA is found in two forms in your blood i.e. bound and unbound. Bound PSAs are encased in a circulating protein while unbound or free PSAs are not.

The normal PSA test measures your total PSA level. Since other conditions like prostatitis and BPH can cause an elevated level, you can use the free PSA level test to determine who needs a biopsy and who is at a higher risk for prostate cancer. Research has shown that men with a free PSA score that is higher than 25% tend to have a benign condition while men with a reading that is less than 10% are more likely to be diagnosed with prostate cancer.

One of the benefits of the free PSA test is that it can save a patient from having to undergo invasive procedures (e.g. biopsy) or expensive scans.

What can I expect at my doctor’s visit?

You will first have a consultation with one of our competent doctors to ascertain your symptoms and if you are in the risk category for prostate cancer. You will be asked questions regarding your medical history, family medical history, and medications that you are currently taking. A physical examination is then performed. A digital rectal exam (DRE) is done to gauge the texture and approximate size of your prostate gland. Additionally, it will scan for any abnormal masses. Then a blood sample is taken for the PSA level test. The results may take a few days so your doctor will need your contact information and you will be advised if a follow-up appointment is necessary.

What is the next step if my PSA level is high?

If you are deemed low risk based on your PSA level and risk factors, you may be asked to be on the lookout for symptoms and repeat the PSA test. 

However, if you are considered high risk, further assessments may be required. 

Close monitoring, also called Watching Waiting or Active Surveillance, and repeat PSA testing can allow doctors to monitor the rate of PSA level increases. This is called PSA Velocity. 

A high-risk patient will be referred for further testing that involves scans such as magnetic resonance imaging (MRI) and transrectal ultrasounds. Depending on the results of your scan, a prostate biopsy (ultrasound-guided prostate tissue sampling for pathological evaluation) would be the next step. 

The prostate sample can deliver a Prostate cancer diagnosis and also give a grading of the cancer using the Combined Gleason Score (CGS).

Exactly what is PSA Velocity?

The PSA Velocity is the PSA level change rate over time. It helps your doctor decide if and when it is necessary to proceed with further scans or a biopsy.

Higher rates of PSA increase i.e. more than 2.0 ng/ml per year can be an indication of prostate cancer, infections, or enlargement.

What are the symptoms of Prostate cancer?

Firstly, sometimes there are no symptoms of Prostate cancer and symptoms are not always an indicator that it is present in the body.

However, here is a list of symptoms that should not be ignored especially if you are in the high-risk group. A visit to your doctor is strongly advised.

  • Difficulty or Hesitance to start urination
  • Frequent Urination (especially during the night
  • Dribbling and an inability to stop urination
  • Blood in urine or semen
  • Difficulty getting and maintaining an erection
  • Weak or sporadic urine flow 
  • Uncomfortable ejaculation
  • Bone pain (usually in the pelvis, lower back, and thigh bones from the metastasized disease

What treatment is available for prostate cancer?

Fortunately, there are many treatment options that are effective especially if prostate cancer is detected early. Survival rates are now up to 90%.

Your oncologist will advise you on the appropriate treatment for the stage and grade of the disease. These can include radiation therapy, hormonal chemotherapy, or surgery (robotic microsurgery).

Speak to us today if you have further questions on prostate cancer screening!

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