Beginning at about age 50 (earlier if your family history suggests it), all men should consider starting routine screening for prostate cancer. Routine screening includes two types of tests—both are simple and relatively painless.
The first test is the digital rectal exam (DRE). For this test, your doctor will lubricate a gloved finger and gently insert it into your rectum. The prostate is just in front of the rectum, and if yours is enlarged or irregular in shape, the doctor will easily be able to detect it. The test is quite brief, and it might be uncomfortable, but it should not be painful.
The PSA Test
The second type of test is equally simple: the PSA test. This is a blood test, and since your doctor will already be drawing blood for other tests, the test order can just be added to the list. Results should be back within about 14 days.
The PSA test measures the level of prostate-specific antigen, or PSA, in your blood. PSA is a protein produced by the prostate, and a rising PSA level can be one of the first signs of prostate cancer. A PSA level under 3.0 ng/mL is considered “normal,” but there are other factors that can cause higher PSA levels. In order to evaluate the results of your PSA test, your doctor will take into consideration:
- Your age
- Your prostate size
- The results of your previous PSA tests
- Other medical conditions, such as BPH or prostatitis
- Whether you’ve taken any medications that may artificially lower PSA, such as finasteride (Proscar or Propecia) or dutasteride (Avodart)
- A history of infections and procedures involving the urinary tract that can elevate the PSA
Your Test Results
Prostate enlargement and higher PSA levels can be a normal part of the aging process, or they could indicate that prostate cancer has begun to develop. Your doctor will always take into account your particular health history: your age, your weight and previous medical history, and your family history and ethnicity, all of which can influence your likelihood of developing prostate cancer.
Learn more about the risk factors for prostate cancer.
If your prostate isn’t enlarged and your PSA level is within normal range, your doctor will likely suggest repeating the tests at regular intervals of 1-2 years as part of your normal checkups.
If your prostate shows signs of enlargement or irregularity, or your PSA level comes back a little high, your doctor may suggest repeating the tests after an interval of time to see if your prostate has changed further or your level is on the rise–an indication of a potential problem.
There are many reasons why a man’s prostate may be enlarged–the presence of cancer is only one. So, even if your doctor finds something unusual, it may not mean that you have prostate cancer. The next steps could include repeating the tests, performing an ultrasound exam of your prostate, or taking a biopsy of the prostate gland.
Want more information? Download or order a print copy of the Prostate Cancer Patient Guide.