Prostate Cancer and PSA Screening Tests

Tuesday, June 04, 2002

Janelle Davis
Public Relations Strategist
American Academy of Family Physicians
(800) 274-2237 Ext. 5222

LEAWOOD, Kan. — Prostate cancer is the most common type of cancer found in American men, other than skin cancer. It is estimated that there will be about 179,300 new cases of prostate cancer in the United States this year, and about 37,000 men will die of this disease. For an American man, the lifetime risk of dying from prostate cancer is more than 3 percent.

Although men of any age can get prostate cancer, it is found most often in men age 50 and older. African-American men are at higher risk than Caucasian men. Men with a family history of the cancer (father or a brother had prostate cancer) are also at a higher risk.

Possible symptoms of prostate cancer include:

  • difficulty starting to urinate;
  • less force to the stream of urine;
  • frequent urination;
  • blood or pus in the urine;
  • pain or burning feeling while urinating;
  • pain with ejaculation; and
  • hip or back pain that does not go away over time.

All men have prostate specific antigen (PSA) in the blood, but a high PSA level may be a sign of prostate problems. Individuals who experience any of these symptoms should contact their family physician and discuss the symptoms and possible course of action.

A prostate-specific antigen (PSA) screening test can be performed by a doctor to look for the cancer before it causes symptoms. However, this test also detects conditions that aren’t cancer. This means some men may have to go through unneeded tests and worry to make sure that they don’t have cancer. PSA screening also detects many cases of slow-growing cancers that cause few if any problems.

The American Academy of Family Physicians (AAFP) recommends that physicians counsel men between the ages of 50 and 65 regarding the known risks and uncertain benefits of PSA screening. All men should be informed of the known harms and uncertain benefits of screening and make an informed choice, rather than routinely screening men’s prostate specific antigen levels.

Treatment options for prostate cancer include “watchful waiting.” This means leaving the cancer alone and seeing a family physician regularly so he or she can track the cancer. This may be a good option for older men and those with slow-growing cancer. Even without treatment, these men typically can expect to live as long as men who don’t have prostate cancer.

Surgery, radiation and drugs are other treatment options. They can cure prostate cancer if it’s caught early. However, these treatments can cause serious problems, such as impotence (inability to get or keep an erection) and incontinence (loss of urine). Surgery or radiation may help treat the more aggressive cancers that are most often found in middle-aged men.

Regardless of the individual’s age or ethnic background, he should make an appointment to speak with his family physician to find out more about prostate cancer and to determine if a PSA screening test is right for him.

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Founded in 1947, the AAFP represents 129,000 physicians and medical students nationwide. It is the only medical society devoted solely to primary care.

Family physicians conduct approximately one in five office visits -- that’s 192 million visits annually or 48 percent more than the next most visited medical specialty. Today, family physicians provide more care for America’s underserved and rural populations than any other medical specialty. Family medicine’s cornerstone is an ongoing, personal patient-physician relationship focused on integrated care.

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