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The Latest on Prostate Cancer Screening Techniques
Prostate cancer is the second most common cancer among men, with some 200,000 cases diagnosed in the U.S. each year.
“Considering how often prostate cancer occurs in men, every man should familiarize himself with its signs and risk factors,” said Alexander Kutikov, MD, FACS, Chief of the Division of Urologic Oncology at Fox Chase Cancer Center. “Yet, not all men should be screened for prostate cancer. Ultimately, the decision to get screened needs to be weighed in terms of the advantages and disadvantages of screening. It is a good idea for men to discuss their options along with risk factors and personal preferences with a provider whom they trust.”
Early prostate cancer rarely causes symptoms, therefore regular screening is an effective way to find and diagnose this disease when it is easiest to treat with surgery or radiation. The American Urological Association recommends that men ages 55-69 consider screening and talk it over with their physician.
Most prostate tumors grow slowly and some men may never be affected by it and most men will not die from it. However, advanced stages of the disease can become aggressive and spread to other organs, which will require systemic treatments.
“I encourage patients to educate themselves about the issue of screening, as it is quite complex,” Kutikov said.
If you are a good candidate for screening, the following techniques are used to determine if cancer is present and, if so, what stage, grade and type the tumor is. These factors help doctors design the most appropriate treatment.
Digital Rectal Exam (DRE)
Screening for prostate cancer usually begins with an exam performed by your doctor in the office as part of a regular medical checkup. The prostate, which is part of a man’s reproductive system, is a walnut-sized organ located in the lower abdomen. In a quick and painless digital rectal exam (DRE), the doctor inserts a gloved finger into the rectum to check the size of the prostate and determine if any parts of it are lumpy or abnormal.
Prostate Specific Antigen (PSA)
A blood test can check your levels of a protein called prostate specific antigen (PSA), which is produced by the prostate gland. The levels of PSA can help indicate whether the organ is working normally.
PSA levels may depend on your age, ethnicity, medical history, and other factors. So, an elevated PSA level doesn’t always mean you have cancer. In fact, two-thirds of the time, a high PSA level has nothing to do with cancer — and some prostate cancers don’t cause an increase in PSA at all.
Learn more about the lastest prostate screening guidelines here.
MRI and Biopsies
If an exam and/or a PSA test suggest that further investigation is warranted — for instance, if your doctor detects a lump in your prostate and/or your PSA level is elevated — then the next step may be a biopsy, in which your doctor will remove very small samples of prostate tissue for analysis. An MRI may also be used to detect a tumor and can at times help avoid a biopsy. Fox Chase was the first in the region to use the UroNav fusion targeted biopsy system, which uses MRI and ultrasound images to locate the ideal places to take tissue samples. This process may find tumor sites that wouldn’t be noticed in a regular biopsy.
How to treat prostate cancer depends on the stage of a tumor and other factors. Prostate cancer treatment includes robotic minimally invasive, radiation, and/or systemic treatments with chemotherapy or hormone therapy. Many patients with very slow growing tumors may be candidates for “active surveillance,” in which doctors keep a close watch over the size and growth progress of the tumor before treatment is decided. Fox Chase also offers a health promotion and lifestyle wellness program called REASSURE ME and is intended to improve the quality of life of men diagnosed with prostate cancer on active surveillance and their spouses.