Author: Leslie Toldo
After skin cancer, prostate cancer is the second most common cancer among men in the U.S., and it is also the second leading cause of cancer death among men after lung cancer.
Over the years, especially within the last decade, prostate cancer screening guidelines have changed dramatically. The guidelines even vary between different organizations. The core message in most health organizations’ recommendations is that whether to screen is something men should decide for themselves.
“Men should absolutely have a discussion with their doctor about whether prostate cancer screening is necessary and when it should start,” said Dr. Prabhat Pokhrel of the McLaren Flint Family Medicine Residency Center. “After weighing all of the factors involved, men can make an informed decision about whether to be screened for prostate cancer.”
Factors to consider include risk for prostate cancer, age, and symptoms. The American Cancer Society recommends men start talking to their doctors about screening:
- When they are 50 or older, if at average risk and expected to live longer than 10 years.
- When they turn 45, if at high risk, including African American men and those who have a first-degree relative (brother or father) diagnosed with prostate cancer before age 65.
- Those Oover 40 who are at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age.)
If a man decides to be screened for prostate cancer, his doctor may recommend a digital rectal exam and a prostate-specific antigen (PSA) blood test. However, these tests can produce both false negative and positive results, and researchers are currently working on more accurate tests.
Also, normal PSA levels are age dependent. Generally, for men 60 years and older, PSA level less than 4.0 ng/mL is considered non-elevated, and for men 59 years of age or younger, PSA level less than 2.5 ng/mL is considered non-elevated. If a man’s PSA level is elevated based on their age, his doctor may refer him to see a urologist for MRI and/or a biopsy
“Generally, prostate cancer screening is recommended once a year. Men who have PSA levels less than 2.5 ng/mL may be rescreened every 2 years,” said Dr. Pokhrel. “If the PSA level is higher, screening should be done yearly to monitor for changes. A rising PSA may be cause for concern and your doctor may check your PSA level every six months.”
When it comes to cancer, early detection can always save lives, because cancers found early are easier to treat. However, a prostate cancer diagnosis does not always lead to immediate treatment. In many cases, a doctor may recommend watchful waiting.
“It is a strategy used for slow-growing cancers, which prostate cancer often is,” said Dr. Pokhrel. “During watchful waiting the patient is monitored for symptoms and health status changes. It is typically used for older men and those with other health issues where cancer treatment side effects outweigh the benefits of treatment.”
Early-stage prostate cancer often doesn’t cause any symptoms, but as cancer progresses, men may experience:
- Frequent urination
- Difficulty urinating
- Incontinence
- Erectile dysfunction and other sexual symptoms
- Bone pain
- Fatigue
- Weight loss
The American Cancer Society estimates there will be more than 300,000 new prostate cancer cases in 2025 and nearly 36,000 deaths. That’s why it is important for men to start the prostate cancer screening conversation with their doctors so they can make the best, most informed decision for their personal health.
McLaren Flint is working with Mid-Michigan NOW and former news anchor Bill Harris on a free prostate cancer screening event for veterans. Free PSA screenings, which consist of a simple blood test, will be available to attendees, along with several other health screenings. It will be Thursday, Nov. 6 from 4 p.m. until 6 p.m. at the McLaren Flint Family Medicine Residency clinic, G3230 Beecher Road, Suite 1 in Flint.
If you are interested in scheduling an appointment, call (810) 342-4473.
If you are looking for a primary health care provider, McLaren has a great resource available at mclaren.org/primarycare.