Prostate Cancer

Early Detection Saves Lives

Early Prostate Cancer Detection

Prostate cancer (PCa) screening offers the best chance of getting ahead of it. How we screen for PCa might differ based on age, health level, or family history, but the first step in screening for prostate cancer is a conversation with your doctor.

The second step might not be as complicated as you think. In fact, your doctor may recommend a simple blood test, called the prostate-specific antigen (PSA) test, that can be added to your routine physical.

The PSA test measures the level of PSA in your blood. It does not specifically test for cancer. Virtually all PSA is produced by the prostate gland. The normal range depends on your age. A PSA above the typical range may indicate the possibility of prostate cancer. However, two-thirds of cases of elevated PSA are due to noncancerous conditions such as prostatitis and BPH.

A DRE is generally conducted by a urologist to feel the prostate. While DRE is no longer recommended as a routine test for men who do not have symptoms of prostate cancer, it may be used to check for any changes in the prostate before doing a biopsy.

If either of these tests suggests an abnormality, other tests are necessary to confirm a diagnosis of prostate cancer, usually a magnetic resonance imaging (MRI) scan and transrectal ultrasound (TRUS) biopsy.

Early Stages and Symptoms

In its early stages, prostate cancer may not show any symptoms. Symptoms of early prostate cancer can include:

  • difficulty passing urine

  • a slow, interrupted flow of urine

  • frequent passing of urine, including at night

  • incontinence.

Symptoms associated with advanced prostate cancer include:

  • blood in urine

  • pain during urination

  • lower back or pelvic pain.

These symptoms are also found in men who may have benign prostatic hyperplasia (BPH), a common, non-cancerous enlargement of the prostate gland. 

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What's Your Number?

PSA screening has yielded a dramatic transformation in how prostate cancer patients present — meaning, the status of their disease when they first get the diagnosis. More men begin care with early-stage and potentially curable disease.

The PSA test is a blood test that measures a protein released in the blood by prostate cells. The higher a man’s total PSA level, the more likely he is to have prostate cancer. A few things to keep in mind about this test:

  • Both normal and cancerous prostate cells secrete the protein.

  • Elevated PSA levels are usually caused by noncancerous conditions, such as benign prostatic hyperplasia or prostatitis.

  • Some men who have prostate cancer do not have elevated PSA.

While there is no perfect screening test for prostate cancer, a PSA test is the most common screening.

If you're a Veteran we consider you to be at high risk for prostate cancer due to factors like being exposed to hazardous materials and radiation sources. In addition, if you are African American or have a family history of the disease, screening discussions typically begin earlier than the standard recommendations. We at VPCa find no harm in having a discussion with your doctor at the age of 40.

  • Veteran Men: Discussions about screening should start around age 40, as this group has a higher risk of developing prostate cancer and tends to be diagnosed at more advanced stages.

  • African American Men: Discussions about screening might start around age 40-45, as this group has a higher risk of developing prostate cancer and tends to be diagnosed at more advanced stages.

  • Family History: If you have a family history of prostate cancer, especially if a close relative (father, uncle, brother, grandfather) was diagnosed at a younger age, screening discussions might also commence around age 40 to 45 or even earlier, depending on the specifics of your family history.

For those at very high risk due to multiple family members affected by prostate cancer at a young age, discussions might even start as early as age 40.

However, the decision to screen should be made after a thorough discussion with your healthcare provider, weighing the potential benefits and risks of screening based on your individual risk factors, age, overall health, and personal preferences. Regular discussions and evaluations will help determine the best approach for your situation.