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Prostate cancer is the third leading cause of death among males with any type of cancer. The prostate is in front of the rectum and below the bladder. Its purpose is to make fluid that becomes part of the semen. The prostate does not play a role in libido or the ability to get an erection.  Prostate cancer occurs when the cells of the prostate grow out of control.

Prostate cancer is not the same as benign prostatic hypertrophy (BPH). BPH occurs as the prostate enlarges as a male age. It can cause symptoms such as slow stream, incomplete bladder emptying, frequent urination and burning with urination. Prostate cancer may not cause any symptoms. When exist, symptoms may include burning with urination, blood with urination, difficulty with urinating, slow stream, trouble emptying the bladder or back or pelvic pain or pain with ejaculation.

The chance of getting prostate cancer increases as a male age. Black males are more likely to get prostate cancer and are twice as likely to die from prostate cancer. Black males also tend to get more aggressive prostate cancer and at a younger age. Risk of prostate cancer increases if a male has one or more first degree relatives (son, brother, father) with prostate cancer.

As with any cancer for which there is screening, the purpose for prostate cancer screening is to detect prostate cancer early before it spreads.  A doctor orders a PSA (prostate specific antigen) blood test as the first form of screening. PSA is only produced by the prostate. Therefore, a high PSA level can occur in BPH, prostate infection and cancer. A PSA may necessitate a biopsy to determine if a high-level means presence of prostate cancer. Biopsy helps to diagnosis and grade the aggressiveness of the cancer. A digital rectal exam may also be performed but there is lack of evidence that such exam is beneficial.

There is disagreement on what age prostate cancer should begin. The American Cancer Society recommends prostate cancer screening starting at age 50. The US. Preventative Services Task Force recommends starting at age 55. American Urological Association recommends checking every 2 years beginning at age 55. Medicare pays for screening once a year. This is usually done during the yearly physical exam, but you should feel free to discuss screening with your primary care doctor at any time. Medicare and other insurance pay for screening PSA once a year. It is important to understand that screening is done when you have no symptoms.


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