Attention Men: Are You Keeping Track of Your Prostate Health?Cancer Care
If you are a man over the age of 50, you should talk to your healthcare provider about your risk of developing prostate cancer, say the experts. When men take care of their prostate health, they give themselves the best chance to prevent and control prostate cancer.
Dr. Paul Bretton, a board-certified urologist with Lee Health Urology, shares his expertise on why it’s important to talk with your doctor about getting tested for prostate cancer and whether a PSA test is right for you.
“The likelihood of developing prostate cancer increases with age,” Dr. Bretton says. “That’s why it’s recommended for men around age 50 to talk to their healthcare provider about their risk of developing prostate cancer and when to begin having a prostate-specific antigen screening – or PSA test.”
According to the United States Preventive Services Task Force (USPSTF), a group of healthcare experts, prostate cancer screening mostly benefits men ages 55 to 69. One in nine men will be diagnosed with prostate cancer in his lifetime, and 270,000 new cases are diagnosed every year. Nearly 2 out of 3 of these men will be 65 or older.
Dr. Bretton stresses that men shouldn't be lulled by the myth that the disease will only strike after a certain age. Patients with a family history or a genetic predisposition are also at risk.
Prostate cancer risks include:
Age. As you get older, your risk of prostate cancer increases. After age 50, your chance of having prostate cancer is increased.
Family history of prostate cancer: Be aware of your family history. Having a father, brother, or son with prostate cancer increases your risk. A man who has two or three first-degree family members with prostate cancer is 11 times at greater risk than someone who has no family members with prostate cancer.
Race: Black men have a higher risk of developing and dying from prostate cancer than men of other races and ethnicities.
“Men who are at high risk should get tested every year,” Dr. Bretton says. “That includes men who are smokers, overweight, between the ages of 45 and 65, or with a family history of cancer. Again, early detection saves lives.”
What’s a PSA test?
A PSA test is one of the most common methods doctors use to screen for prostate cancer. Some men use the PSA test to screen for prostate cancer.
“The prostate-specific antigen (PSA) test is a blood test that measures the level of PSA in the blood,” Dr. Bretton explains. “PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men with prostate cancer. Generally, the higher the PSA level in the blood, the more likely of a prostate problem.”
Dr. Bretton adds that other conditions that affect the prostate can raise PSA levels, such as an enlarged prostate and infections in the prostate or bladder.
Because many factors can affect PSA levels, your urologist is the best person to interpret your PSA test results. If the PSA test is abnormal, your doctor may recommend a biopsy to find out if you have prostate cancer.
What are the benefits of getting a PSA test?
Prostate cancer screening tests aim to find cancers that may be at high risk for spreading if untreated and to find them early before they can spread. However, most prostate cancers grow slowly or not at all.
Identifying cancer early may lower the need for more aggressive treatment, which may lower the risk of side effects such as incontinence and erectile dysfunction.
“Many men with prostate cancer never experience symptoms and, without screening, would never know they had the disease,” Dr. Bretton says.
What are the harms of getting a PSA test?
Prostate cancer screenings can pose some harm, according to experts.
A false-positive test result is a common risk associated with PSA screening. This happens when a man has an elevated PSA level but doesn’t have cancer. False-positive test results can cause needless anxiety, confusion, and worry about one’s health. Also, they can lead to other unnecessary tests, like a prostate biopsy, which can cause possible side effects such as infection, pain, and bleeding. A new innovative test, called the 3T MRI of the prostate, can be used to avoid unnecessary biopsies of the prostate. Read our blog story about this new test HERE.
A PSA test can help detect small tumors. However, the decision to treat that small tumor may not lower one’s risk of dying from prostate cancer. That’s because some tumors grow so slowly that they’re unlikely to be life-threatening. The detection of these types of tumors is called “overdiagnosis.”
“Overtreatment” involves treating slow-growing tumors, which unnecessarily exposes one to the potential complications associated with prostate surgery and radiation therapy. These can include urinary, gastrointestinal, and sexual side effects.
Dr. Bretton says that if found early, many prostate cancers grow slowly and may not cause any health problems.
“If you’re 55 to 69 years old, talk to your doctor about the benefits and harms of screening,” he says. Identifying health conditions early gives you and your doctor the most flexibility in treatment options.
“Most men diagnosed with prostate cancer don't die from it. In fact, more than 2.9 million diagnosed men in the United States are still alive today.”
Currently, Medicare provides coverage for an annual PSA test for all Medicare-eligible individuals ages 50 and older. Many private insurers cover PSA screening as well.
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