To Screen or Not to Screen for Prostate Cancer? It Depends.
September is Prostate Cancer Awareness Month. If you’re thinking about screening, here’s why you first need to have a conversation with a physician about the potential benefits – and risks.
By Thomas Vincz, Public Relations Manager
The best approach to prostate cancer would seem to be simple enough: get screened, so you can detect the cancer as early as possible and give yourself a better chance of treating it effectively.
But with any condition as serious as prostate cancer – the second leading cause of cancer death among men – it’s not that simple.
On one hand, detecting prostate cancer before it causes symptoms can make it easier to treat. On the other hand, screening can lead to potential risks like false positives or unnecessary surgeries. What’s a man to do?
The good news: men don’t have to answer that question by themselves. In fact, it’s recommended they don’t.
According to the latest guidelines from the American Cancer Society, men who are considering prostate cancer screening are advised to have a conversation with their primary care doctor about the uncertainties, risks and potential benefits of screening. That’s because several factors go into when – or if – men can benefit from screening.
Here are the general screening guidelines from the Prostate Cancer Foundation for men with no unusual prostate-related symptoms:
- For men at average risk of prostate cancer, they should have the discussion at age 50. About 60 percent of cases are diagnosed in men aged 65 or older, and it is rare before age 40.
- For African-Americans, age 45 is the right time to talk with a doctor. Research shows African-Americans are 76 percent more likely to develop prostate cancer than a Caucasian man, and more than twice as likely to die from the disease.
- For men who have a family history of the disease – such as more than one first-degree relative (father, brother or son) diagnosed with prostate cancer at age 65 or younger – the conversation should happen at age 40.
Because prostate cancer is usually slow-growing, men with a life expectancy of less than 10 years do not generally benefit from screening. That’s why it’s not recommended for men age 70 or older to be screened. However, for specific individuals, men should have a conversation with their doctor.
Screening Recommendations from Prostate Cancer Foundation
Your PCP can help
A visit to a primary care physician (PCP) can be the ideal place to start this discussion. These doctors can help men make the right screening decision. And if the decision is “yes,” a PCP can also conduct an initial screening.
In most cases, this is done through a prostate-specific antigen (PSA) blood test. PSA is a substance made by cells in the prostate gland that can be high in men with prostate cancer. A digital (finger) rectal exam of the patient may also be included as part of prostate cancer screening.
If screening results suggest more complex tests are needed, a PCP can then make a referral to a specialist, such as a urologist.
Know what to look for
Screening is so important because early prostate cancer usually causes no symptoms. But men should be looking out for these possible signs of more advanced cancer:
- Frequent urination or difficulty starting or stopping urination
- Blood in the urine or semen
- Pain or stiffness in the lower back, hips, or upper thighs
- Difficulty having an erection
- Painful ejaculation
Many of these symptoms are more likely caused by something other than prostate cancer. Talking with a PCP can help find the real cause and set up treatment if needed.
Extra support for men diagnosed with prostate cancer
One out of nine men in the US will be diagnosed with prostate cancer in his lifetime. Horizon members in this situation can receive extra guidance on how to navigate the care they need.
The Complex Case Management Program from Horizon BCBSNJ is a free, voluntary service that helps members connect to the right resources as they receive treatment such as radiation or surgery. These services can range from helping members get the necessary authorizations for diagnostic imaging to setting up home care once they’ve been discharged from the hospital.
“Case managers are also there to offer emotional support and help our members make the decisions that are best for them,” said Roida Taylor, RN, a case manager at Horizon BCBSNJ with more than 20 years of experience caring for patients with cancer. “This is a difficult time for our members, and we’re someone they can feel comfortable talking to.”
Once members are diagnosed with prostate cancer, their doctor can request a case manager to reach out to a patient. Members can also request case management services through the Horizon Blue website.
Start the conversation
The path to prostate cancer diagnosis and treatment can be filled with twists and detours. But a visit to a PCP can be a cost-effective first step on that journey.
Find a Horizon BCBSNJ in-network PCP here.