Because it can help detect prostate cancer at its earliest and most treatable stages, prostate specific antigen (PSA) testing can be a good idea. That said, this particular screening may not be necessary for some men. According to the U.S. Preventive Services Task Force (USPSTF), men ages 55 to 69 should talk to their doctors about the potential benefits and risks of PSA testing. The USPSTF recommends against PSA-based screening for prostate cancer in men 70 and older.
There are two tests commonly used to screen for prostate cancer:
- Digital rectal exam (DRE): In this test, a doctor or nurse physically examines the prostate to estimate its size, as well as feel for any lumps or abnormalities.
- PSA test: This test measures the level of PSA (a substance made by the prostate) in the blood. While the levels of PSA in the blood can be higher in men who have prostate cancer, elevated PSA levels can also indicate other prostate conditions.
Again, deciding to have prostate cancer testing is something that men should discuss with their health care providers. To help you prepare for your conversation, here are some pros and cons of the PSA test:
| Pros of PSA Test | Cons of PSA Test |
|---|---|
| Early detection of prostate cancer. | Prostate cancer can be slow growing and never spread beyond the prostate. |
| Treatment is most effective when cancer is detected in its earliest stages. | Not all prostate cancer requires treatment. Treatment of prostate cancer also poses risks and side effects, such as urinary incontinence, erectile dysfunction and bowel dysfunction. |
| It’s a simple, widely available blood test. | PSA tests aren’t perfect. PSA levels can be elevated when cancer isn’t present and not elevated when cancer is present. |
| Reassurance—knowing is better than not knowing. | A diagnosis of prostate cancer can cause stress and confusion over treatment options, especially if the cancer isn’t life threatening. |
Understanding prostate cancer and your individual risk factors for the disease can help you make an informed decision about screening, too. The primary risk factors for prostate cancer include:
- Age—after age 50, your risk rises significantly
- Race—black men have a higher risk of developing and dying of prostate cancer
- Family history of the disease
- A high-fat diet
- Obesity
If you’re diagnosed, the good news is the five-year survival rate for most men with local or regional prostate cancer is nearly 100 percent. When prostate cancer is found early, your doctor may recommend active surveillance (monitoring changes over time). Other treatment options include radical retropubic prostatectomy (RRP) or robotic-assisted laparoscopic prostatectomy (RALP). Western Michigan Urological Associates performs both of these procedures, as well as several other advanced, minimally invasive options for prostate concerns.
John Ludlow, MD
John K. Ludlow, M.D. is a board-certified urologist with Western Michigan Urological Associates. He obtained his medical degree from the University of Southern California and completed his residency through Indiana University. Unique to only a few urology training programs in the country, Dr. Ludlow had the opportunity to develop skills under leading experts in prosthetic urology for the treatment of erectile dysfunction and incontinence. He continues to advance his knowledge and surgical skills with additional training in Urological Oncology and Reconstructive Urology.