Risk Of Prostate Cancer
About 1 man in 8 will be diagnosed with prostate cancer during his lifetime.
Prostate cancer is more likely to develop in older men and in non-Hispanic Black men. About 6 cases in 10 are diagnosed in men who are 65 or older, and it is rare in men under 40. The average age of men at diagnosis is about 66.
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Screenings Can Lead To High Costs
The cost for a PSA test is fairly lowabout $40.
If your result is abnormal, the costs start adding up. Your doctor will usually refer you to a urologist for a biopsy. Costs may include:
- A consultation fee .
- An ultrasound fee .
- Additional professional fees .
If the biopsy causes problems, there are more costs. You might also have hospital costs.
What Do The Results Mean
PSA levels may be above the baseline for various reasons other than prostate cancer.
Other factors that can raise PSA levels include:
- an enlarged prostate â because of benign prostatic hyperplasia , for example
- prostatitis, which is inflammation and swelling of the prostate
Also, people with obesity may have lower PSA readings.
In addition, some medications may reduce PSA levels, including:
- 5-alpha reductase inhibitors, which can help treat BPH
- aspirin, which some people take regularly as a blood thinner
- statins, which help manage cholesterol levels
- thiazide diuretics, a kind of water pill that can help reduce high blood pressure
Some herbal medicines and supplements can also lower PSA levels. Tell the doctor about any medications and supplements before undergoing the test.
High PSA levels alone do not indicate cancer. However, if a DRE also reveals changes, a doctor may recommend a biopsy for a more accurate result.
The PCA3 is another test for prostate cancer that doctors use in some circumstances. Find out more.
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How Often Should Men Have A Prostate Screening
A prostate screening is extremely important to have regularly. Because, without them, a mans health is at a high risk of developing prostate cancer. Knowing how often prostate screenings should be had can be helpful to those men who are not sure.
A mans health is just as important to maintain as a womans. But most people are under the assumption that womens health needs more attention. However, that is not true. Men are at risk of developing prostate cancer, and it can become very problematic if not addressed.
Keep reading to find out how often a man should have a prostate screening.
What Is The Psa Test
PSA stands for prostate specific antigen. Its a protein made by both normal and cancerous prostate cells. Its normal for all men to have some PSA in their blood.
A high level of PSA can be a sign of prostate cancer. But your PSA level can also be raised because of other conditions that arent cancer. This includes:
- a urine infection
- a benign enlarged prostate
The PSA test can also miss some prostate cancers. Research has shown that 1 in 7 men with a normal PSA level have prostate cancer. And that 1 in 50 men with a normal PSA level have a fast growing prostate cancer.
Because of this, the PSA test on its own is not recommended as a screening test for prostate cancer. But men over 50 can usually ask their GP for a PSA blood test if they want. Your GP will explain the potential benefits and risks of having a PSA test.
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Should You Know Your Psa Level
Instead of a national screening programme, there is an informed choice programme, called prostate cancer risk management, for healthy men aged 50 or over who ask their GP about PSA testing. It aims to give men good information on the pros and cons of a PSA test.
If you’re aged 50 or over and decide to have your PSA levels tested after talking to a GP, they can arrange for it to be carried out free on the NHS.
If results show you have a raised level of PSA, the GP may suggest further tests.
What Are The Prostate Cancer Symptoms I Need To Look Out For
In its early stages, prostate cancer may not show any symptoms. Symptoms of early prostate cancer can include:
- difficulty passing urine
Symptoms associated with advanced prostate cancer include:
- pain during urination
- lower back or pelvic pain.
These symptoms are also found in men who may have benign prostatic hyperplasia , a common, non-cancerous enlargement of the prostate gland.
If you experience these symptoms, visit your doctor.
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What Is A Dangerous Psa Level
PSA levels are measured as a number of nanograms in each milliliter of fluid tested. This is written as ng/mL.
- PSA level 2.5 ng/mL or lower: This is a normal PSA level for those under age 60, but in some cases, prostate cancer may still be present.
- PSA level between 2.5 and 4 ng/mL: This is a normal PSA level for most people.
- PSA level between 4 and 10 ng/mL: This indicates that prostate cancer might be present. At this level, there is about a 25% chance that you have prostate cancer.
- PSA level 10 ng/mL or above: There is a 50 percent chance that prostate cancer is present. The higher the PSA rises above 10 ng/mL, the greater the chance that you have prostate cancer.
Your doctor may also monitor your PSA velocity, or doubling time, which means recording your baseline PSA the level at your very first PSA test and seeing how fast the PSA level increases over time. Rapid increases in PSA readings can suggest cancer. If your PSA is slightly high, you and your doctor may decide to keep an eye on your levels on a regular basis to look for any change in the PSA velocity.
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What Happens During A Dre Examination
The DRE requires the insertion of a gloved and lubricated finger into the rectum by a doctor to check the size of the prostate and confirm the presence or absence of any abnormalities. This test is important because it can uncover signs of prostate problems that may require further testing, which is why its usually the first test performed.
Men who have conditions like hemorrhoids are strongly advised to inform their doctor so that worsening of the condition by the test can be prevented.
The PSA blood test is the current recommended test for screening. Typically taking place after the DRE, the PSA test detects levels of the protein-specific antigen, made by the prostate, in the blood.
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When Is It Time To Stop Being Checked For Prostate Cancer
Its essential to be fully informed about the potential risks of PSA testing, which includecomplications from biopsies and teratments.
The answer depends on your current health and your level of concern about cancer.
Routine PSA testing to check for prostate cancer is no longer recommended for most men. But despite what the experts suggest, many men continue to opt for annual PSA tests. This includes a surprisingly large number of men in their 70s. In a recent study in the journal Cancer, more than half of a group of men 75 and older had PSA tests and biopsies.
These men have placed their hope in the value of early diagnosis and treatment, yet stand to gain less from PSA testing than younger men. Across all ages, routine PSA screening leads to life-saving treatment for cancer in about one in every 1,000 men screened.
Force guidelines: These independent experts on preventive medicine do not recommend PSA screening for prostate cancer in men at any age, due to a lack of definitive evidence that the benefits of PSA testing are greater than the risks.
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Risks And Benefits Of Psa Test
There are benefits of having a PSA test which include early detection of prostate cancer. The earlier cancer is detected, the better the chance of a cure.
There are also risks involved. These include:
- Worry about false-positive results caused by elevated PSA levels from something other than prostate cancer. A raised PSA result could be from something benign
- Invasive, stressful, expensive or time-consuming follow-up tests
- Stress or anxiety caused by knowing you have a slow-growing prostate cancer that doesnt need treatment
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This examination lasts “15 to 20 seconds,” according to Ehdaie, and is “uncomfortable” but “not painful.” Rettig noted that on its own, the digital exam is “not going to add very much,” but can be paired with the blood test to give a full picture of the patient’s health situation.
After that exam is completed and the bloodwork is done, the results are “evaluated together.”
“A decision would be made to either pursue further tests because the screenings suggest there may be something that would be of concern, or they would return at the next scheduled ,” Ehdaie said.
Specialist Referral And Biopsy
Your doctor will discuss your prostate check results with you. If the PSA and DRC results suggest you have a high risk for prostate cancer, your doctor will refer you to a urologist .
The specialist will discuss having a prostate biopsy, in which a small sample of your prostate gland cells are taken for examination.
The aim of the biopsy is to confirm whether or not you have prostate cancer and, if so, whether it needs treatment. The treatment options will then be discussed with you.
If the biopsy shows no evidence of cancer, you may be advised to attend future check-ups.
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Dr. Behfar Ehdaie, a urologic surgeon specializing in prostate cancer at Memorial Sloan Kettering Cancer Center in New York, said that these varying guidelines are due to the different risk factors that each person faces. Things like family history, environmental factors, race and more can all come into play when it comes to assessing prostate cancer risk.
“There are specific patient level factors that have to go into that decision, including family history, comorbidities, and life expectancy,” said Ehdaie, who said that people who are not expected to live more than another decade may not be advised to get screened. “And of course, the patient’s own preferences are taken into account, their goals, what they want to achieve.”
Why Should I Get Both Prostate Cancer Screenings
Both screenings provide valuable information about your health that can detect prostate cancer, even at an early stage. One result without the other may not provide enough indication of whether or not treatment is necessary.
There are many reasons why a mans prostate may be enlarged, and prostate cancer is only one. When paired with a PSA blood test, results can better indicate whether further testing is needed to determine a diagnosis.
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Points To Remember About Referral Guidelines
- While reading these guidelines, it is important to remember that
- PSA testing of men who do not have symptoms or PSA screening is not national policy, a proistate assessment consisits odf a digital rectal examination and a PSA test.
- PSA testing should only be carried out after full advice and provision of information
- More than 99 out of every 100 men diagnosed with prostate cancer are over 50
- About 75 out of every 100 men diagnosed with prostate cancer are over 70
- The cumulative risk of a man developing prostate cancer before the age of 50 is 1 in 485 and before the age of 70 is I in 13
- Difficulty passing urine is common in the general population and on its own, is not a reason for your GP to suspect prostate cancer
- The most common signs of prostate cancer are a raised PSA blood test and an abnormality found by your GP during an examination of your prostate
- A normal PSA reading varies depending on your age
- Men with a first degree relative who have prostate or breast cancer are at a higher risk of developing prostate cancer themselves
When To Start Pca Screening
There is no consensus regarding the age at which to initiate PSA-testing . Most guidelines recommend that discussions about PSA screening start around ages 4555 with well-informed men in good health and a life expectancy of at least 1015 years. The core age group in the ERSPC trial started screening between ages 5569. The AUA guideline supports starting screening at age 55 based on the ERSPC trial and because of the risk of overdiagnosis in younger men, but also acknowledge that men at higher risk for PCa can start before 55.
A recent analysis of the U.S. PLCO trial specifically studied characteristics of 151 men who died from PCa within 13 years of follow-up and were randomized to the screening arm. The authors found that more than half of these men were never screened and they were also older at study start than the average participant .
Critical for balancing the benefits and harms of screening, particularly the risk of overdiagnosis, is the age to stop screeningwhich is covered in another article in this issue of TAU . For instance, stopping screening at age 70 can reduce overdiagnosis by 42% .
Albright and colleagues analyzed data from 600,000 men in the population-based SEER registry with information on family history and found that the relative risks of lethal PCa varied with the number of affected first-degree relatives .
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What You Need To Know About The Prostate What Age Do You Start Prostate Screening
A enlarged prostate can also cause blockages in the urethra. A blocked urethra can also damage the kidneys. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. If pain is present, a digital rectal examination will reveal hard areas. A doctor may prescribe surgery or perform an endoscopic procedure. If the enlarged prostate is not completely removed, it will shrink.
While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. Some men have minimal or no symptoms at all. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Generally, the symptoms can stabilize over time. Some men may have an enlarged prostate but not notice it. If they have an enlarged colon, their physician can perform a TURP procedure.
Study Finds Family History Of Prostate Cancer Supports Earlier Screening For These Men
A large nationwide cohort study in Sweden has found that men with a family history of prostate cancer have a greater risk of being diagnosed with an advanced phase of the disease making it more likely to be fatal. This has now warranted that screening guidelines be adjusted to include men with a family history of prostate cancer be advised to screen earlier for the disease than men in the general population.
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Can I Check My Own Prostate
It is not recommended that you try to check your own prostate.
The prostate is an internal gland, and performing a self-examination could cause harm. For your safety, the exam should be performed by a licensed healthcare professional.
Additionally, a professional will be better able to assess if there is a reason for concern.
What Is Cancer Screening
Screening means testing people for early stages of a cancer, or for early changes that could develop into cancer if left untreated. For screening to be useful the tests:
- need to be reliable at picking up cancers that need treatment
- overall must do more good than harm to people taking part
- must be something that people are willing to do
Screening tests are not perfect and have some risks. The screening programme should also be good value for money for the NHS.
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Causes Of Prostate Cancer
The causes of prostate cancer are largely unknown. But certain things can increase your risk of developing the condition.
The chances of developing prostate cancer increase as you get older. Most cases develop in men aged 50 or older.
For reasons not yet understood, prostate cancer is more common in black men and less common in Asian men.
Men whose father or brother were affected by prostate cancer are at slightly increased risk themselves.
Recent research also suggests that obesity increases the risk of prostate cancer.
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Two Main Screening Tests
There are two tests commonly used to screen for prostate cancer:
- The Digital Rectal Exam : A doctor or nurse inserts a gloved, lubricated finger into the rectum to estimate the size of the prostate and feel for lumps or other abnormalities.
- The Prostate Specific Antigen Test: This exam measures the level of PSA in the blood. The levels of PSA in the blood are often higher in men who have prostate cancer. The PSA level may also be high in other conditions that affect the prostate.Usually, the higher the bloods PSA level is, the more likely it is that a prostate problem is present. But other factors, such as age and race, also can raise PSA levels. PSA levels also can be impacted by certain medical procedures, some medications, an enlarged prostate or a prostate infection.Since your PSA level may be high for other reasons, your doctor will need to interpret the test results.
If the results of the PSA and/or DRE suggest that you might have prostate cancer, your doctor will need to do a prostate biopsy to find out. This means a sample of your prostate tissue will be removed with a needle and sent to a lab, where a specialist will determine if it contains cancer cells.
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