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Prostate cancer: when should men be tested?

Categories: Cancer

Prostate cancer testing is currently creating considerable debate. However, as one of the most prevalent cancers in the U.S., prostate cancer should be an important health concern for every man. The key is early detection and personalized care.

“At Hoag Family Cancer Institute, we take an individualized approach to prostate cancer care, recognizing that no man’s cancer is the same as the next,” states Jeffrey Yoshida, M.D., program director of Hoag Urologic Oncology. “Prostate cancers are not created equal. Therefore, depending on the individual’s ethnicity, family history, age and exposure to potential risks, an individualized treatment plan is a man’s best option.”

Hoag recommends that men who are at increased risk for prostate cancer, such as men of African American descent, or who have a family history ofprostate cancer, begin screening at age 40. For all other men with a life expectancy of at least 10 years, the American Urological Association (AUA) recommends consideration of a baseline PSA test beginning at age 40, with subsequent screening utilizing PSA testing and digital rectal examination as determined by a physician. In contrast, the American Cancer Society (ACS) recommends consideration of prostate cancer screening beginning at age 50.

An abnormal PSA level, or significant rise in PSA over time, would require further testing which may include a prostate biopsy. There are numerous factors besides cancer which can influence a PSA level, such as BPH (benign prostatic hyperplasia), urinary tract infections and prostatitis. While only 25 percent of prostate biopsies will actually reveal cancer, it is essential that an abnormal PSA level or significant PSA rise be investigated.

Some men diagnosed with prostate cancer are eligible to participate in active surveillance, also known as “watchful waiting.” Active surveillance is a method of monitoring slow growing prostate cancers. It relies on serial PSA testing and an annual biopsy to identify if there is cancer progression.

For men with more aggressive forms of prostate cancer, intervention may be necessary, such as radiation therapy or surgery. There are numerous treatment options, however so, it is recommended that a man speak with his physician.