Here it is vital to understand that prostate cancer is very slow-growing and generally does not cause any early symptoms. Thus, the only way to detect prostate cancer early enough is with the help of diagnostic tests.
The most common screening method used to detect cancer is the prostate-specific antigen (PSA) blood test accompanied with a digital rectal examination. However, one should understand that even if this test is positive, it does not essentially mean cancer. Thus, if this test is positive, doctors would still carry out other various tests, and in some cases they might even recommend a prostate biopsy.
If you are unsure whether you should get screened for prostate cancer or not, then the recommendation is pretty simple. If you are above the age of 40 and have a family history of prostate cancer, you should get screened. Those without a family history and any prostate issues should still get screened for prostate cancer if they are older than 50 years of age.
Prostate cancer screening tests
PSA testing is the most commonly recommended blood test for prostate cancer screening, and all men between the ages of 50-70 should get this test done. However, high-risk individuals may get this test done more frequently. The test can also be done in high-risk individuals below the age of 50 like those:
- With a family history of prostate cancer
- Who had frequent urinary or sexually transmitted infections or are living with prostatitis
- People with a sedentary lifestyle and living with various metabolic disorders
- Those who had high exposure to toxins like herbicides
Free PSA testing
There are two kinds of PSA tests. One is bound with the circulating proteins, and another is free PSA. In high-risk individuals, testing for free PSA is also essential, as studies show that those with free PSA above 25% have a low risk of prostate cancer. However, free PSA below 10% may suggest a greater risk of prostate cancer.
As already mentioned, PSA tests along with a digital rectal exam might suggest a cancer risk. However, none of these tests are confirmatory. Hence, doctors would need to order a prostate biopsy if there is clinical suggestion of prostate cancer. Prostate biopsy is invasive as it involves taking a sample of prostate tissues and examining them under the microscope. Alternatively, a doctor may order a Prostate Health Index(PHI) test to help differentiate a benign PSA elevation from a cancerous elevation and reduce the need for a biopsy. A key metric is prostate velocity. It is regarded as high if PSA increases at the rate of > 2.0 ng/ml per year. This may suggest either prostate cancer or some chronic prostate infection.
Prostate cancer symptoms
Before we discuss various prostate cancer symptoms, a word of caution, remember that prostate cancer may not produce any symptoms in its early stages. Moreover, even in later stages, symptoms may be similar to those found in BPH. Hence, prostate cancer is always diagnosed with the help of various lab tests.
Nevertheless, there are some of the signs and symptoms that may suggest a higher risk of prostate cancer, like:
- Trouble starting urination
- Frequent urination at night
- Dribbling and weak urine flow
- Blood in urine
- Difficulty in maintaining an erection for long enough
- Painful ejaculation
- Bone pains like those of thigh bones, pelvis, and lower back
- Prostate cancer treatment options
Prostate cancer can be cured in majority of cases if diagnosed early enough. Even if it is diagnosed late, treatment can considerably prolong life, as medications can slow down its progression.
Like all cancers, doctors may combine different treatments like chemotherapy, hormonal drugs, immune therapy, radiotherapy, and even surgical removal of the prostate gland. The choice of treatment depends on many factors, like the Gleason score, stage of disease and the patient’s age.