Prostate Cancer Screening
The main tools used in screening for prostate cancer are the digital rectal examination (DRE) and the prostate-specific antigen (PSA) test. The DRE and PSA tests cannot tell if you have cancer; they can only suggest the need for further tests.
Digital Rectal Exam
The DRE is an exam of the rectum. The doctor or nurse inserts a lubricated, gloved finger into the lower part of the rectum to feel the prostate for lumps or anything else that seems unusual.
Prostate-Specific Antigen Test
This test measures the level of PSA in the blood. PSA is a substance made mostly by the prostate that may be found in an increased amount in the blood of men who have prostate cancer. These levels may also be high in men who have an infection or inflammation of the prostate or benign prostatic hyperplasia (BPH -- an enlarged, but noncancerous, prostate).
Decisions about screening tests can be difficult. Not all tests are helpful, and most have risks. Before having any screening test for prostate cancer, you may want to discuss it with your doctor. It is important to know the risks of the test and whether it has been proven to reduce the risk of dying from cancer.
The risks of screening include the following:
- Finding prostate cancer may not improve health or help a man live longer
- False-negative test results
- False-positive test results.
No Improvements for Health or Longevity
Prostate cancer screening may not improve your health or help you to live longer if you have advanced disease or if it has already spread to other places in your body (metastasized).
Some prostate cancers never cause symptoms or become life-threatening, but if found by a screening test, the disease may be treated. It is not known if treatment of these cancers would help you to live longer than if no treatment were given, and treatments for cancer may have serious side effects.
Side effects of prostate cancer treatment may include:
- Complications of major surgery
- Incontinence (inability to control the bladder or bowels)
- Impotence (inability to have or keep an erection).
False-Negative Test Results
Screening test results for prostate cancer may appear to be normal even though disease is present. A man who receives a false-negative test result (one that shows there is no cancer when there really is) may delay seeking medical care, even if he has symptoms.