By Cancer.Net Editorial Boardcancer.net3 min
Screening is used to look for cancer before you have any symptoms or signs. When cancer is found earlier in its development, it is often at an earlier stage. This means that there is a better chance of successfully treating the cancer. Scientists have developed, and continue to develop, tests that can be used to screen a person for specific types of cancer. The overall goals of cancer screening are to:
- Lower the number of people who die from the disease, or eliminate deaths from cancer altogether
- Lower the number of people who develop the disease
Learn more about the basics of cancer screening.
Screening information for prostate cancer
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:
- Digital rectal examination (DRE). A DRE is a test in which the doctor inserts a gloved, lubricated finger into a man’s rectum and feels the surface of the prostate through the bowel wall for any irregularities.
- PSA blood test. There is controversy about using the PSA test to look for prostate cancer in men with no symptoms of the disease. On the one hand, the PSA test is useful for detecting early-stage prostate cancer, especially in men with many risk factors, which helps some men get the treatment they need before the cancer grows and spreads. On the other hand, PSA screening finds conditions that are not cancer, such as BPH, in addition to very-slow-growing prostate cancers that would never threaten a man’s life. As a result, screening for prostate cancer with PSA may mean that some men have surgery and other treatments that may not be needed, which can cause side effects and seriously affect a man’s quality of life.
ASCO recommends that people with no symptoms of prostate cancer not receive PSA screening if they are expected to live less than 10 years. For those expected to live longer than 10 years, ASCO recommends that they talk with their doctors to find out if the test is appropriate for them.
Other organizations have different recommendations for screening:
- The U.S. Preventive Services Task Force (USPSTF) recommends that men between 55 and 69 should discuss the pros and cons of PSA screening with their doctor before making a decision about screening. Men who are 70 and older should not have routine PSA screenings for prostate cancer.
- Both the American Urological Association and the American Cancer Society recommend that men be told the risks and benefits of testing before PSA screening occurs and then make an informed decision in consultation with their doctor.
- The National Comprehensive Cancer Network considers a patient’s age, PSA value, DRE results, and other factors in their recommendations.
It is not easy to predict which tumors will grow and spread quickly and which will grow slowly. Everyone should discuss their situation and personal risk of prostate cancer with their doctor so they can work together to make an informed decision.
Symptoms and Signs
Often, prostate cancer is found through a PSA test or DRE in men who have early-stage disease and no symptoms or signs, a process called screening. If a PSA test or DRE indicates that prostate cancer may be present, more monitoring and testing is needed to diagnose prostate cancer. When prostate cancer does cause symptoms or signs, it is usually diagnosed in a later stage. These symptoms and signs may include:
- Frequent urination
- Weak or interrupted urine flow or the need to strain to empty the bladder
- Blood in the urine
- The urge to urinate frequently at night
- Blood in the seminal fluid
- New onset of erectile dysfunction
- Pain or burning during urination, which is much less common
- Discomfort when sitting, caused by an enlarged prostate
Sometimes men with prostate cancer do not have any of these changes. Or, the cause of a symptom may be another medical condition that is not cancer. Other noncancerous conditions, such as BPH or an enlarged prostate, can cause similar symptoms. Urinary symptoms also can be caused by an infection or other conditions.
If cancer has spread outside of the prostate gland, a man may experience:
- Pain in the back, hips, thighs, shoulders, or other bones
- Swelling or edema in the legs or feet
- Unexplained weight loss
- Change in bowel habits
If you are concerned about any changes you experience, please talk with your doctor. Your doctor will ask how long and how often you have been experiencing the symptom(s), in addition to other questions. This is to help find out the cause of the problem, called a diagnosis.
If cancer is diagnosed, relieving symptoms remains an important part of cancer care and treatment. This may also be called symptom management, palliative care, or supportive care. Be sure to talk with your health care team about symptoms you experience, including any new symptoms or a change in symptoms.