Screening & Prevention
Prevention of Prostate Cancer
The exact cause of prostate cancer is unknown. A fatty diet, family history, older age and African American ethnicity are the only factors currently known to increase one’s risk for prostate cancer.
Unfortunately, there are often no early warning signs of prostate cancer and without regular screening; prostate cancer can go undetected for years. In some cases, as the tumor grows it may exert pressure on the urethra, blocking the flow of urine from the bladder causing urinary symptoms. Occasionally the first warning sign may be blood in the urine. Note: symptoms may not occur until the cancer has developed to an advanced stage.
Typical symptoms of prostate cancer:
- Frequent urination (especially at night)
- Weak urinary stream
- Inability to urinate
- Interruption of urinary stream (stopping and starting)
- Pain or burning on urination
- Blood in the urine or ejaculate
- Bone pain in the hips, ribs or back
- Back pain
Because there are no early warning signs for prostate cancer men may choose to undergo a screening for the disease. Screening for prostate cancer does not provide a diagnosis, it provides valuable information in finding the disease early. Screening commonly involves two tests: the prostate specific antigen (PSA) blood test, and the digital rectal exam (DRE).
New tests, or biomarkers, such as the PCA3 urine test are under development and may aid in the detection of prostate cancer. A biomarker is a biological molecule found in blood, body fluids, or tissues that is a sign of a normal or abnormal condition or disease. Biomarkers may also be used to see how the body responds to a treatment for a disease.
Digital Rectal Exam (DRE)
A Digital Rectal Exam (DRE) is a quick and safe screening technique in which a physician feels the prostate by inserting a gloved, lubricated finger into the rectum. This simple procedure allows your physician to determine whether the prostate is enlarged, has lumps, areas of hardness or other types of abnormal texture. The entire prostate cannot be felt during a DRE but a significant portion can be examined including the area where most prostate cancers are found. While this examination may produce momentary discomfort, it causes no significant pain.
Prostate-Specific Antigen (PSA) Test
Used in addition to the digital rectal examination (DRE), a prostate-specific antigen (PSA) test increases the likelihood of prostate cancer detection. PSA is a substance produced by bot normal and cancerous prostate cells. When prostate cancer grows or when prostate diseases are present, the amount of PSA in the blood often increases.
The normal PSA range is most commonly considered to be 0-2.5ng/mL. It is important to track how your PSA level changes over time. If you PSA level is rising, regardless of the result value, your doctor may recommend a prostate biopsy.
It is important to know that there are several possible causes of a high PSA level that are not cancer. One is benign enlargement of the prostate called benign prostatic hyperplasia (BPH), and the second is prostatitis. A high level of PSA in the bloodstream may be a warning sign that prostate cancer is present. But since other kinds of prostate conditions may also cause high PSA levels, PSA testing by itself cannot confirm the presence of prostate cancer. A high PSA level only indicates the possibility of prostate cancer and the need for additional evaluation by your physician. Conversely, a low PSA level does not always mean that prostate cancer is not present. An early stage of prostate cancer may be present that has not yet caused the PSA to increase in the bloodstream; it is for this reason that tracking your PSA blood test result over time is important. There are also additional PSA tests available that your physician may recommend.
- Percent Free-PSA Ratio
- PSA Density
- PSA Velocity
- PSA Doubling time
- Prostate Health Index (still under development)