Part of the male reproductive system, the prostate is about the size of a walnut and weighs about an ounce. The prostate makes fluid for semen. The prostate wraps around the urethra, the tube that carries urine from the bladder out through the penis.  As a man grows older, his prostate can enlarge and cause urinary symptoms.  These can include a weak urinary stream, more frequent trips to the bathroom, and getting up at night to urinate. This does not mean that he has prostate cancer. In its early stages, only a few men may have symptoms, such as urinary problems or pain, from prostate cancer.  Because there are no warning signs of localized prostate cancer, screening tests that find cancer early may be recommended by your doctor.

How do doctors detect prostate cancer early?

Screening for prostate cancer can be done in your doctor’s office using two tests. One is a blood test for Prostate Specific Antigen (PSA).  PSA is a protein produced by the prostate tissue.  In the United States, PSA testing is the most common way prostate cancer is detected in asymptomatic men.  The other test is a physical exam called a Digital Rectal Exam (DRE). With a DRE, your doctor will insert a gloved, lubricated finger into your rectum and press on your prostate for just a few seconds.  This will allow your doctor to feel for any irregularities in the size, shape or texture of your prostate that would indicate cancer.  The PSA and DRE can be abnormal even when a man does not have prostate cancer.  If either PSA or DRE is concerning for prostate cancer, a biopsy is needed to prove it.

The goal of prostate cancer screening is to detect the cancer before it has moved outside of the prostate. If the cancer has moved to other parts of the body, the chance of dying from the cancer increases.  Many newly found prostate cancers are confined in the prostate. If not treated, localized tumors can grow and spread to other parts of the body or metastasize. Some prostate cancer tumors grow very fast but most tumors grow very slowly over many years.

Prostate cancer screening can be a valuable part of an annual health maintenance exam. Men at higher risk for prostate cancer include men of African-American descent or men who have one or more immediate family members with prostate cancer.  Screening for higher risk men typically begins at age 40.  Regular screening with annual PSA and DRE is offered to all men over the age of 50.  Not all men may be candidates for prostate cancer screening based on their age or overall health.  If you’re considering prostate cancer screening, have a thorough discussion of the pros and cons of prostate cancer screening with your doctor.

What treatment options are available if cancer is found?

Advancements in prostate cancer treatments have improved overall cure rates and quality of life for prostate cancer survivors.  For example, robotic-assisted surgery with the da VinciÆ system allows precise surgical removal of the prostate while preserving important structures for urinary control and sexual function.  Accounting for the prostate cancer grade and stage, your age, overall health status, and personal preference, your doctor will discuss treatment options such as active surveillance, surgery, radiation therapy or hormone therapy.  Different treatments can have various  benefits and side effects, so take the time to get educated about all your treatment options and review your decision with your doctor.