August 30, 2010
Prostate cancer is a common and life threatening problem for men. Approximately 16 percent of males in the United States (roughly 300,000 men) will be diagnosed with prostate cancer during their lives, and nearly 30,000 will die each year from this disease. Due to these high numbers, detection and appropriate treatment are incredibly important.
Unfortunately, symptoms of prostate cancer rarely present themselves until the very late stages, when curing the disease is usually impossible. There are however, ways to detect the cancer early and thus minimize risk.
A prostate cancer screening, including a rectal exam and a prostate-specific antigen (PSA) blood test, is the best way to take a pro-active approach at catching the disease — and ultimately staying healthy.
Currently, the risks of developing prostate cancer include age, race and family history. The risk of prostate cancer diagnosis increases with age.
Autopsy studies suggest upwards of 30 percent of men in their 60s and 45 percent of men in their 70s have prostate cancer. African-American men also have been shown to have higher rates of prostate cancer than other subgroups of the population. Lastly, family history of prostate cancer in a first-degree relative (father or brother) has been shown to double or triple the risk of prostate cancer. This information provides not only helpful information to men at risk, but is also used in making decisions about the appropriate age to start screening for prostate cancer.
Prostate cancer screening guidelines from the American Urological Association suggest well-informed men should be offered a PSA blood test and rectal exam at age 40. The optimal frequency of the subsequent screening is left to the discretion of the physician.
Presumably men with risk factors, such as a family history or African-American heritage, should be screened more frequently than those without risk factors. Thus, by age 50, most men should have had a baseline PSA and rectal exam, which should be repeated regularly until they reach 75. At age 75, men should stop having PSA tests and be followed only with annual rectal exams for prostate cancer detection.
If you are to get screened for prostate cancer, it’s important to keep in mind that an individualized approach should be taken when looking at the results of your PSA test. The average PSA for a man slowly rises with age, and therefore an abnormal test for one person may not be abnormal for another.
The following shows an average PSA for men at different stages in their lives:
- Ages 40 to 49: Average PSA 0.7.
- 50 to 59: 1.0.
- 60-69: 1.2.
- 70 to 79: 1.5.
In addition, some men (usually with larger prostates) tend to have higher PSA levels than others. Thus, a PSA of no concern for one individual could suggest cancer in another.
The PSA trend over multiple measurements spaced months or years apart is typically the best indicator of prostate cancer risk, and you can rely on your physician to help look at your specific case and needs. If an abnormal PSA is found, the next step would be to undergo a biopsy to detect whether cancer is present.
If you are interested in getting checked yourself, Martha Jefferson Hospital will be holding a free prostate cancer screening on Sept. 18. It is designed for men ages 50 and older, or age 45 if African-American. Men who have no health insurance of primary care physician are encouraged to attend. Screenings are available on a first-arrival basis from 7:45 to 10:45 a.m. at Martha Jefferson Hospital.
- By Dr. Geoff Habermacher, Urological Associates Ltd.
Vital Signs is a community health promotion column sponsored by Martha Jefferson Hospital, Region Ten, Thomas Jefferson Health District, and the University of Virginia Health System.