Prostate cancer affects nearly 11 percent of men and is the second most common cancer in American men. For Prostate Cancer Awareness Month, we explain the cancer and the two most common screenings – the rectal examination and the prostate-specific antigen (PSA) blood test. Prostate cancer is treatable and has a high-survival rate when diagnosed and treated early.
How the Prostate Works
Your prostate is a walnut-sized gland responsible for creating fluid to nourish sperm. Your prostate also produces PSA, a protein found in your semen and blood.
“If your prostate gland has cancerous tissue, cancer cells can be the reason you have increased levels of PSA in your blood,” says Kasey Morrison, MD, a urologist with Adventist HealthCare Adventist Medical Group.
Men with prostate cancer and other prostate abnormalities may experience uncomfortable symptoms, including:
- Trouble passing urine
- Burning or stinging while urinating
- Rectal pain and pressure
- Blood in urine or semen
- Painful ejaculation
Only men have prostates, so they are the only ones who can experience prostate abnormalities. Men who are African American, Afro Caribbean, or have a family history of prostate cancer are at highest risk.
“Most men with average risk are encouraged to discuss the risks and benefits of prostate cancer screenings with their doctor starting at age 55,” says Dr. Morrison. “However, if you are at an increased risk based on your family history or ethnicity, you may want to have these discussions sooner.”
Prostate Screening Options
A rectal examination and the PSA blood test are often used to detect prostate cancer. Remember, an abnormal screening result does not mean you have cancer.
- Rectal Examination: A digital rectal exam is often performed as part of your annual physical. “During this exam, your doctor will feel the prostate gland for bumps or hard areas,” says Dr. Morrison. “Some men may feel mild discomfort during this exam.”
- PSA Blood Test: The PSA blood test involves providing a blood sample to your doctor to determine your PSA level. The normal range on tests is between 0 and 4, but some PSA levels can far exceed these numbers. Dr. Morrison says while levels higher than 4 often indicate a higher risk for prostate cancer, men with high or low PSA levels can still have the disease.“Your doctor can help you understand your results, so you can make the best decision based on your risk,” says Dr. Morrison. “Other, non-cancer-related causes for high PSA levels are an enlarged prostate, inflammation or other urological conditions.”
Diagnosis and Treatment
If the results of one or both tests are abnormal, your doctor will recommend a prostate biopsy to make a diagnosis. Some cancer cases will never spread beyond the prostate and other times the cancer spreads rapidly. If you do have prostate cancer, your doctor can help you decide the appropriate course of action to take based on your unique case.
Sources: National Cancer Institute, U.S. Library of Medicine, American Cancer Society