The Numbers: More than 241,000 new cases of prostate cancer are expected this year in the U.S., making it the leading cancer in men. The good news is that the expected deaths are relatively low, at 28,170.
Risk Factors: The more first-degree relatives (parents, siblings, and children) you have who’ve had prostate cancer, the higher your risk. “If your father had prostate cancer, your risk triples,” says Alan Partin, M.D., urologist-in-chief at Johns Hopkins Medical Institution. “But if your brother also had it, your risk increases even more.” For some reason, African American men are also at increased risk for prostate cancer.
Symptoms May Include: A need to urinate more, or difficulty stopping or starting; blood in the urine or semen; or pain during urination or ejaculation.
How It Progresses: Unchecked, highly aggressive prostate cancer moves into the bones around the spinal column, hips, and their surrounding lymph nodes.
Screening Tests: Screening for prostate cancer involves tandem rectal and blood tests. In a digital rectal exam, a doctor inserts a gloved, lubricated finger into the rectum to feel through the rectal wall for hard or lumpy areas on the prostate. Then, a blood test checks the level of prostate-specific antigen (PSA) in the blood.
Two new tests have recently been approved by the FDA: a urine test that looks for an RNA molecule, and a prostate health index that tests three types of PSA. Both tests work with the traditional PSA blood test to improve the accuracy of prostate screening and help prevent unnecessary biopsies.
Should You Get Screened? Despite some recent studies questioning the efficacy of PSA screening, the numbers seem to show that screening is highly effective. “I’m 51, and when I started practicing, one in four men would get metastatic prostate cancer,” says Partin. “Now it’s one in 100.”
If your family history puts you at high risk, you should start screening at age 40; otherwise, you can begin at 50.
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