Prostate cancer early detection
Screening for prostate cancer is done to find evidence of cancer in otherwise healthy men. Two tests are commonly used to screen for prostate cancer: the PSA blood test and digital rectal examination (DRE, a test in which the doctor inserts a gloved lubricated finger into a man’s rectum and feels the surface of the prostate for any irregularities).
There is controversy about using the PSA test to look for prostate cancer in men with no symptoms of the disease. On one hand, the PSA test is useful for detecting early prostate cancer, which helps men get the treatment they need before the cancer spreads. On the other hand, PSA screening find conditions that are not cancer and slow-growing prostate cancers that would never threaten a man’s life. Because of this, screening for prostate cancer may mean that some men have surgery and other treatments that may not ever be needed. For this reason, many men and their doctors may consider active surveillance (see Treatment) of the cancer rather than immediate treatment.
Because biopsies and treatment have significant side effects, such as impotence (inability to get and maintain an erection) and incontinence (inability to control urine flow) treating it unnecessarily may seriously affect a man’s quality of life. However, it is not easy to predict which tumors will grow and spread quickly and which will grow slowly.
According to a provisional clinical opinion on PSA screening for men with no symptoms of prostate cancer, ASCO recommends that men expected to live 10 years or less should not have PSA screening and men expected to live longer than 10 years should talk with their doctors to find out if the test is appropriate for them. Every man should discuss his situation and risk of prostate cancer and work with his doctor to make a decision. To help with this discussion, ASCO provides a Decision Aid on prostate cancer screening.