Prostate Cancer Screening

Prostate cancer is the most common cancer affecting men with an estimated annual incidence of 300,000 new cases and over 40,000 deaths each year. As men age, the risk of prostate cancer increases. Approximately 5 in 10 men will develop prostate cancer by the age of 85. The average age of men with prostate cancer is about 70 years of age.

The prostate is a walnut-shaped accessory sex gland that sits below the bladder. It has a function in reproduction, producing about 50 percent of the ejaculate volume. It can be readily examined by doing a rectal examination.

Cancer occurs when normal cells change into malignant cells. The goal in any cancer is early detection and prompt treatment to allow for the best long-term results. Prostate cancer is a disease where early detection and prompt treatment are important to improve survival.

There are several risk factors for the development of prostate cancer. A family history of a brother or father with prostate cancer nearly doubles the risk of developing this disease. For unknown reasons, African-Americans are at increased risk of prostate cancer as well. A high-fat diet may be another risk factor.

Since the prostate surrounds the urine channel and may obstruct the flow of urine out of the bladder, many men with prostate cancer will present with a weak urinary stream. However, as men age, the incidence of benign enlargement of the prostate becomes more prevalent. In fact, a poor urinary stream is more likely to be from benign disease of the prostate than cancer.

The prostate is examined by doing a rectal examination. Abnormalities of the prostate can then be determined. Also, a blood test called a Prostate Specific Antigen (PSA) is helpful in screening for prostate cancer. Neither the rectal exam nor the PSA are completely accurate tests, but the two together can often detect prostate cancer. The only sure way to identify prostate cancer is with a prostate biopsy via a small probe placed in the rectum. The probe uses ultrasound waves to image the prostate and a small needle to precisely sample prostate tissue. The pathologist then determines if benign or cancerous tissue is present.

Currently the American Cancer Society recommends a yearly rectal exam and a PSA in all men over 50 years of age. If a man has a family history of prostate cancer or is of African-American descent, screening should begin at age 40 years.

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