Fortunately, the season of terrible Mo-vember moustaches has passed. But the spirit of Mo-vember needs to be remembered all year. Mo-vember is a month to increase knowledge and awareness of men’s health issues like prostate cancer. Who should get tested for prostate cancer? What are the tests? How often are they needed? What is the damned prostate?
The prostate is a walnut sized gland that sits at the base of the bladder. Its main function is to produce one of the fluid components for semen. But for many men as they age, the prostate can create problems. Prostate cancer is a scourge of men’s health. In spite of every technique and technology we’ve invented, it remains the 2nd leading cancer killer of men, surpassed only by lung cancer. When caught early, prostate cancer is a highly curable disease. But when caught late, it is much more dangerous. Unfortunately, by the time prostate cancer causes any symptoms, it is often too late to cure. For this reason, physicians have looked for a method of finding prostate cancer earlier. That method is the PSA test.
PSA Testing and the Dreaded "Finger Wave"
The PSA test is a simple blood test that has been around for decades, it was FDA approved in 1994. PSA is a protein in the blood stream that is made almost exclusively by the prostate. When PSA is higher, or rising, your risk for prostate cancer is higher. The PSA test is used in conjunction with a test called the DRE or digital rectal exam…the dreaded "finger wave." Trust me, this isn’t a fun part of the visit for either the doctor or the patient. However, it is very quick and very important. It could save your life. The "finger wave" is necessary to detect the types of prostate cancer that do not cause a rise in PSA. Up to 25% of prostate cancers actually have a normal PSA level. Most prostate cancer arises in the peripheral zone of the prostate and so it can often be felt when examined by your physician. PSA testing and the prostate exam must work together.
There are certainly situations in which your PSA is elevated, but there is no prostate cancer. Things such as a urinary tract infection, retention of urine, or an enlarged prostate can cause an elevation of PSA. You doctor will work with you to consider these factors. Riding a bike can cause your PSA to rise. Even recent sexual activity can cause an increase in your PSA.
There has been some controversy about the PSA test in the past. Some studies have shown that PSA testing is effective at diagnosing prostate cancer, but not effective at reducing associated cancer deaths. One government agency even gave the test a "D" grade. In spite of this, most research has shown the PSA test helps catch prostate cancer earlier and helps decrease the risk of death from this disease. Nearly every physicians group agrees there is a role for PSA testing. Nearly every urologist agrees. PSA testing is a shared decision that should be made with you and your doctor.
So, What are the Current Recommendations?
The American Urologic Association recommends that PSA testing be considered for all men ages 55-69. PSA testing should begin sooner if you are at high risk. People of African American ethnicity or those with a father or brother who had prostate cancer are at 2.5 times higher risk of prostate cancer. Testing for them should begin at age 45. Many urologists recommend obtaining a baseline PSA test at an earlier age, in the early 40s. If it is normal, it does not need to be repeated frequently. Once you’ve reached the age to begin having your PSA checked, it should be done either annually or every other year. Again, it should always be in conjunction with a prostate exam.
So, now that you know more, it’s time to talk to your doctor about PSA testing. Participate in Mo-vember. Time to get your prostate checked. Midtown Urology is here to support your health.
This Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
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