EARLY DETECTION AND SCREENING
Prostate Cancer Screening
Screening is the necessary testing for a disease such as prostate cancer when symptoms are not present. Screening can help find prostate cancer in its earliest stages where it can be more easily treated and cured. Although many prostate cancer patients are older, do not wait until age 40 to start getting tested. Finding and being able to treat prostate cancer early allows men to have more treatment options with potentially fewer side effects.
DIGITAL RECTAL EXAM (DRE)
This is a quick and simple test that allows the urologist to feel the size, shape and texture of the prostate manually by touch. If any abnormalities are found, the next step is to check the level of the Prostate Specific Antigen in the blood. DRE also helps determine whether a patient has prostate cancer or non-cancerous conditions such as Benign Prostatic Hyperplasia (BPH) or Prostatitis.
PSA BLOOD TEST
Prostate Specific Antigen (PSA) is a natural occurring protein that is produced by the prostate and released into the bloodstream. When prostate cancer starts to develop, more levels of PSA is released into the bloodstream and eventually reaches a level where it is easily detectable. Don’t be afraid. For this screening, just a few drops of blood are drawn from the arm and measurements are then made:
General PSA Guidelines
Normal – 0,0-4.0 nanograms/milliliter – considered safe
Intermediate – 4.1-9.9 nanograms/milliliter – considered safe but can suggest the possibility of prostate cancer so speak with your doctor
High – 10.0 + nanograms/milliliter – dangerous and you should speak with your doctor immediately
Understanding High PSA Levels
Digital Rectal Exams (DRE) should always accompany a PSA Blood Test as they detect issues of the prostate, such as cancer, when used together. Although accurate, an elevated PSA alone does not automatically mean prostate cancer is present.
Higher PSA levels may be caused due to:
- Older Age
- Injury to the prostate
- Extended pressure on the area from the penis to the rectum
- Sex within 24 hours of taking the PSA sample
- Urinary Tract Infection
- Testosterone Supplements
Understanding Low PSA Levels
Generally, a low PSA is a good thing and means you have no further action to take. But, even men diagnosed with prostate cancer can have lower levels of PSA due to dilution.
Lower PSA levels may be caused due to:
- Being overweight or obese (body fat decreased amount of PSA)
- Anti-inflammatory drugs
- Cholesterol decreasing drugs
If either test shows abnormal results, further testing such as a biopsy will be needed to identify whether prostate cancer exists. If both screening formats provide positive “normal” results, you should continue to get tested for prostate cancer every year as part of a comprehensive physical examination.
If a DRE or PSA blood test shows abnormal results, a urologist will evaluate the patient by doing a prostate ultrasound. In a prostate ultrasound, a finger-sized probe is inserted into the rectum and produces high-frequency sound waves that are completely harmless and inaudible to the human ear. The sound waves reflect and bounce off of the prostate, which are then converted to produce video or photo images. These visuals provide the doctor with the information to approximate the size of the prostate as well and identify any abnormalities.
When abnormalities have been detected, on the ultrasound, the doctors will use the same imaging technology to guide several tiny needles through the walls of the rectum and into various areas of the prostate. Each one of the needles removes and carries with them a small amount of prostate tissue, which is then analyzed in a laboratory. If prostate cancer is identified, the doctor will use the results from the biopsy to help diagnose and grade the cancer if it is identified.