What is Prostate Cancer?
What is Prostate Cancer? – Hi my name is Dr. Rob Mordkin, and I am the US Medical Director for LetGetChecked here today to talk to you about PSA and specifically screening for prostate cancer. Prostate cancer is a very common disease that affects men in their prostate gland and for those of you that don’t know the prostate is a small gland that’s located deep in the pelvis just below the bladder and just above the rectum. Screening involves typically two approaches and both are important.
One is blood testing of something called PSA, we’ll come back to that in a moment and the second part of testing or screening for prostate cancer vitally important is a digital rectal exam which means palpating or feeling the prostate through the rectum, through the rectal wall. Understandably many men shy away from this portion of the exam, but it is important, at least important in early detection and quite frankly, the test itself, the rectal exam, shouldn’t take more than five to ten seconds in your doctor’s office,
As far as the blood test goes PSA, PSA stands for prostate specific What is that what is prostate specific antigen. What is that, well it’s a protein that’s formed by cells, prostate cells, and laboratories can now measure the levels of that antigen of that protein in the bloodstream.
Important to understand though that this is a controversial test and the controversy quite frankly is well earned. The reason it’s controversial is that testing PSA and an elevated level of PSA in the bloodstream does not always mean that the man in fact has prostate cancer.
Even more concerning is that a normal PSA does not always 100% rule out that a man does not have prostate cancer. But we do know that there is a correlation between the PSA blood levels and the possibility for prostate cancer and so the higher the PSA level the greater the potential that that person has prostate cancer. How does one diagnose prostate cancer?
Well ultimately it requires a prostate biopsy which is a procedure that can be either performed in the office under a local anesthetic or perhaps under a mild IV sedation medicine but the procedure itself the biopsy takes more than five minutes and a result is usually obtained within a week or so.
Patients will often ask me how do I know if I’ve got prostate cancer in other words are there symptoms or signs that I might have that the diseases is present and unfortunately prostate cancer is very insidious. Meaning, that you won’t have any signs or symptoms of prostate cancer until the disease is well progressed. Meaning not that it’s in the prostate anymore but that it’s spread to distant portions of the body.
Once that’s happened, quite frankly, the horses out of the barn, the train has left the station and so my challenge or goal is to try to detect the disease well before that would happen well before there were any symptoms and this brings us back to this importance of testing, PSA testing and rectal exam testing.
Who should be tested? Well, as a general recommendation any man who does not have a family history of prostate cancer or any man who is not African-American should probably have a baseline test, again PSA and rectal exam, starting at about age 50 and then if we assume that initial test is normal or within the normal ranges then perhaps every other a year going forward.
Conversely however, if a man has a relative who’s had prostate cancer or if they’re African-American, then testing earlier and more often makes the most sense. Even starting as early as age 40 and perhaps doing testing as often as annually.
This type of determination can be made in conjunction with a urologist or a physician who often deals with prostate cancer and it’s a shared responsibility understanding that many men may have prostate cancer that does not need to be treated so it’s not always that straightforward or easy conversation and the decision about who to test and win the test should be shared between the physician and the patient but again the call to action here is if you have a family history of the disease if you’re African-American getting testing and getting tested early makes the most sense.
If you’re curious and you want to advocate for your own health getting tested as a baseline at age 50 would be my call to action. If you’d like more information about this I invite you to visit LetsGetChecked.com and either through live chat or direct phone conversation you can talk to one of our nursing team members.