The purpose of screening is to detect prostate cancer at its earliest stages, before any symptoms have developed. Some men do experience symptoms that might indicate the presence of prostate cancer. These symptoms can also indicate the presence of other prostate diseases or disorders (such as BPH or prostatitis), so these men will undergo a more thorough workup.
Typically, prostate cancer that’s detected by screening is in the very early stages and can be treated most effectively. Physicians can screen for prostate cancer quickly and easily in their office using two tests: the PSA (prostate-specific antigen) blood test and the digital rectal exam (DRE).
The PSA Blood Test
PSA is a protein produced by the prostate and released in very small amounts into the bloodstream. When there’s a problem with the prostate—like the development and growth of prostate cancer—more and more PSA is released. It eventually reaches a level where it can be easily detected in the blood.
During a PSA test, a small amount of blood is drawn from the arm, and the level of PSA is measured:
- Levels under 4 ng/mL are usually considered “normal.”
- Levels over 10 ng/mL are usually considered “high”
- Levels between 4 and 10 ng/mL are usually considered “intermediate.”
PSA is not a perfect test. Levels can be elevated if other prostate problems are present, such as BPH or prostatitis. Some men with prostate cancer may even have low levels of PSA. PSA can also be diluted in men who are overweight or obese, due to a larger blood volume, and a biopsy at a relatively lower number (i.e. 3.5 instead of 4) should be considered.
The Digital Rectal Exam
During a DRE, the physician inserts a gloved, lubricated finger into the rectum and examines the prostate for any irregularities in size, shape, and texture. Often, the DRE can be used by urologists to help distinguish between prostate cancer and non-cancerous conditions such as BPH.
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Important to Note
Many men will be found to have cancer even with “normal” results from the PSA test and DRE.
Your decision about what to do next in this circumstance should be based on your age, other risk factors, and the specifics of your type of cancer (grade, stage, etc).
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Terms to know from this article:
Checking for disease when there are no symptoms.
The removal of cells or tissues for examination under a microscope. When only a sample of tissue is removed, the procedure is called an incisional biopsy or core biopsy. When an entire lump or suspicious area is removed, the procedure is called an excisional biopsy. When a sample of tissue or fluid is removed with a needle, the procedure is called a needle biopsy or fine-needle aspiration.
The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer.
prostate-specific antigen (PSA): A substance produced by the prostate that may be found in an increased amount in the blood of men who have prostate cancer, benign prostatic hyperplasia, or infection or inflammation of the prostate.
see benign prostatic hyperplasia