Prostate Cancer Screening

Screening for prostate cancer is a controversial topic. The concern is not that digital rectal exams and prostate specific antigen (PSA) results cannot identify early-stage cancers. Both sides agree that this is true. Opponents of regular screening suggest that positive screening results may lead to unnecessary prostate cancer treatment and needless anxiety.

PSA Results and The Case For Screening

PSA results and other forms of screening allow men to access prostate cancer treatment during the early stages of their disease. Whether immediate treatment is required or not, symptoms can be monitored in case the condition worsens. Early screening and early detection, proponents argue, can save lives. The argument is simple, but powerful.

The Case Against Screening

The argument against screening is somewhat more complex. A recent study by the U.S. Preventive Services Force states that no hard evidence indicates that early detection of prostate cancer affects the eventual outcome of the disease. Most men diagnosed with prostate cancer are over the age of 65. Only three percent of men diagnosed will die from the disease. As the disease progresses very slowly, in most cases, most men diagnosed will actually die from other causes.

While fifteen percent of American males will be diagnosed with the disease, only eight percent actually need surgery or other treatment. Early detection, opponents argue, often leads to unnecessary treatment. Surgery and radiation therapy can have unwanted side effects, including urinary incontinence, bowel dysfunction and erectile dysfunction.

Opponents object to the needless anxiety and stress that a diagnosis generates. If early detection of the disease will not change the outcome, they argue, why bother upsetting men with the test results? Perhaps this is a case where what men don’t know won’t hurt them.

Watchful Waiting

For many men, a diagnosis of prostate cancer results in what urologists refer to as “watchful waiting.” Symptoms of the disease are monitored, but treatment is not undertaken unless symptoms increase in severity.

The Choice is Yours

Choosing whether to undergo prostate testing or not is an individual decision. Some men prefer to know; some would just as happily remain unaware. The same reasoning applies to treatment side effects: some men would prefer to have early treatment, and run the risk of side effects. Others would prefer to wait and see if their symptoms worsen. Of course, your decision should be based on relevant issues such as age and risk factors, like a family history of prostate disease.

The information on this site explores the different types of prostate cancer screening.

The American Cancer Society recommends that men over the age of 50 should get digital rectal exams (DREs) on a regular basis.

The prostate specific antigen (PSA) test is a blood test that is used frequently to screen for prostate cancer.

Often called the visual prostate exam, prostate imaging will allow urologists to actually see the prostate gland.

Though screening can give urologists some information, the only real way to confirm that a man has prostate cancer is to conduct a tissue biopsy of the area.

Resources

American Cancer Society. (2003). What are the key statistics about prostate cancer? Retrieved January 28, 2003, from www.cancer.org/docroot/cri/content/cri_2_4_1x_what_are_the_key _statistics_for_prostate_cancer_36.asp?sitearea=cri.

American College of Physicians-American Society of Internal Medicine. (1997, March). Screening for prostate cancer. Annals of Internal Medicine, 126, 480-484. Retrieved January 22, 2003 from www.acponline.org/journals/annals/15mar97/ppscreen.htm.

Kelly, D. (nd). IWW: Intelligent watchful waiting. Retrieved January 24, 2003 from www.brachytherapy.com/WW.html.

Mayo Foundation for Medical Education and Research. (2002). Prostate cancer screening: Know your options. Retrieved January 23, 2003 from www.mayoclinic.com/invoke.cfm?id=HQ01273.

National Center for Chronic Disease Prevention and Health Promotion. (reviewed 2002). Prostate cancer screening: A decision guide. Retrieved January 23, 2003 from www.cdc.gov/cancer/prostate/decisionguide/index.htm.

National Library of Health. (updated 2001). Lymph node biopsy. Retrieved January 24, 2003 from www.nlm.nih.gov/medlineplus/ency/article/003933.htm.

The Prostate Centre, University of Toronto. (revised 2003). Diagnosing cancer. Retrieved January 23, 2003 from www.library.utoronto.ca/medicine/prostate/diagnosis.html.

Roach, M., Kurhanewicz, J.