Psa Screening Risks And Benefits
In recent years, PSAscreening has come under fire because of concerns that it has led to overdiagnosis and overtreatment. At Fred Hutchinson Cancer Center, we believe there are several good reasons to continue PSA screening.
A protein made by the prostate gland and found in the blood. Prostate-specific antigen blood levels may be higher than normal in men who have prostate cancer, benign prostatic hyperplasia , or infection or inflammation of the prostate gland.
PSAscreening has yielded a dramatic transformation in how prostate cancer patients present â meaning, the status of their disease when they first get the diagnosis. More men begin care with early-stage and potentially curable disease.
A protein made by the prostate gland and found in the blood. Prostate-specific antigen blood levels may be higher than normal in men who have prostate cancer, benign prostatic hyperplasia , or infection or inflammation of the prostate gland.
PSAscreening has likely saved many lives, but it also uncovers many cases of prostate cancer that may not need to be treated. The main harm in screening is not the PSA test itself but the possibility that the results may lead to overtreatment of low-risk cancers in older men.
A protein made by the prostate gland and found in the blood. Prostate-specific antigen blood levels may be higher than normal in men who have prostate cancer, benign prostatic hyperplasia , or infection or inflammation of the prostate gland.
Is The Psa Test Recommended For Prostate Cancer Screening
Beginning around 2008, as more was learned about both the benefits and harms of prostate cancer screening, a number of professional medical organizations began to caution against routine population screening with the PSA test. Most organizations recommend that individuals who are considering PSA screening first discuss the risks and benefits with their doctors.
Some organizations do recommend that men who are at higher risk of prostate cancer begin PSA screening at age 40 or 45. These include Black men, men with germline variants in BRCA2 , and men whose father or brother had prostate cancer.
In 2018, the United States Preventive Serves Task Force updated its recommendation statement for prostate cancer screening from a D to a C in men ages 55 to 69. The updated recommendation, which applies to the general population as well as those at increased risk due to race/ethnicity or family history, is as follows:
- For individuals ages 55 to 69 years, the decision to undergo periodic PSA-based screening for prostate cancer should be an individual one. Before making the decision, a person should discuss the potential benefits and harms of screening with their clinician and consider these in the context of their own values and preferences.
- PSA-based screening for prostate cancer is not recommended for individuals 70 years and older.
How Soon Will Prostate Test Results Be Available
Results for simple medical tests such as some urodynamic tests, cystoscopy, and abdominal ultrasound are often available soon after the test. The results of other medical tests such as PSA blood test and prostate tissue biopsy may take several days to come back. A health care provider will talk with the patient about the results and possible treatments for the problem.
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Prostate Cancer Care At Medstar Georgetown Cancer Institute
If you need a second opinion on your PSA level after screening for prostate cancer, youâll benefit from our team approach and broad experience. At the MedStar Georgetown Cancer Institute, our cancer team involves experts from a variety of disciplines, including urologists, medical oncologists, radiation oncologists, and others who work closely together to evaluate which treatment option will benefit you the most. We treat more patients for prostate cancer than most health systems in the region, so you can trust that we have the tools and the experience necessary to care for you.
Donât let the fear of a prostate cancer diagnosis keep you from getting a prostate cancer screening. Talk to your doctor about getting your PSA checked early so that you can seek timely treatment, if necessary, and continue doing the things you love while youâre in the prime of your life.
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Possible Inaccurate Or Unclear Test Results
As an example, neither the PSA test nor the DRE is 100% accurate. These tests can sometimes have abnormal results even when a man does not have cancer , or normal results even when a man does have cancer . Unclear test results can cause confusion and anxiety. False-positive results can lead some men to get prostate biopsies when they dont have cancer. And false-negative results can give some men a false sense of security even though they might actually have cancer.
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Genetic Testing For Some Men With Prostate Cancer
Some doctors now recommend that some men with prostate cancer be tested to look for certain inherited gene changes. This includes men in whom a family cancer syndrome is suspected, as well as men with prostate cancer that has certain high-risk features or that has spread to other parts of the body. Talk to your doctor about the possible pros, cons, and limitations of such testing.
What Is A Dangerous Psa Level
PSA levels are measured as a number of nanograms in each milliliter of fluid tested. This is written as ng/mL.
- PSA level 2.5 ng/mL or lower: This is a normal PSA level for those under age 60, but in some cases, prostate cancer may still be present.
- PSA level between 2.5 and 4 ng/mL: This is a normal PSA level for most people.
- PSA level between 4 and 10 ng/mL: This indicates that prostate cancer might be present. At this level, there is about a 25% chance that you have prostate cancer.
- PSA level 10 ng/mL or above: There is a 50 percent chance that prostate cancer is present. The higher the PSA rises above 10 ng/mL, the greater the chance that you have prostate cancer.
Your doctor may also monitor your PSA velocity, or doubling time, which means recording your baseline PSA the level at your very first PSA test and seeing how fast the PSA level increases over time. Rapid increases in PSA readings can suggest cancer. If your PSA is slightly high, you and your doctor may decide to keep an eye on your levels on a regular basis to look for any change in the PSA velocity.
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When Should Men Get A Prostate Exam
According to the American Cancer Society, men and people who were assigned male at birth should have their first prostate exam by age 50. If you have a family history of prostate cancer, you should consider having your first prostate exam at age 45.
Additionally, Black men are at a higher risk for being diagnosed with prostate cancer. For this reason, healthcare providers often recommend that Black men have their first prostate exam around age 45.
Various Treatments For Enlarged Prostate
Before opting for treatment, your doctor will do a few tests to see if the prostate enlargement is severe. If your condition isnt good, the doctor will recommend the following treatments. Along with the disease, the doctor will consider your prostate size, age, health, and if you suffer from any other medical conditions.
- Alpha-Blockers for BPH. The doctor will recommend this to loosen the bladder neck muscles and its fiber in the prostate. When the power is relaxed, it is easier to pee, and there will be an increase in urination. You will not pee frequently. It is effective after two days of taking the alpha-blocker. Some of the alpha-blockers are Hytrin, Uroxatral, Flomax, Rapaflo, and Cardura.
- 5- Alpha-Reductase Inhibitors for BPH. It is one of the ways on how to shrink the prostate. It blocks hormones that grow the prostate glands, thus reducing the prostate size. There are two types of 5- alpha-reductase inhibitors, namely Avodart and Proscar. These inhibitors are effective after three to six months.
- TUNA Treatment. TUNA is a short form of transurethral needle ablation and is one of the trusted prostate enlargement home remedies. This treatment procedure uses two needles, which carry high-frequency radio waves that inflame a particular region in the prostate. The treatment allows men to have good urine flow and decreases the BPH symptoms. You can do the treatment at home the doctor will use an anesthetic to prevent burning sensation.
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When Is A Psa Test Needed
If you are age 50 to 74, you should discuss the PSA test with your doctor. Ask about the possible risks and benefits.
Men under 50 or over 75 rarely need a PSA test, unless they have a high risk for prostate cancer.
- You are more likely to get prostate cancer if you have a family history of prostate cancer, especially in a close relative such as a parent or sibling.
- Your risks are higher if your relative got prostate cancer before age 60 or died from it before age 75. These early cancers are more likely to grow faster.
- If you have these risks, you may want to ask your doctor about getting the PSA test before age 50.
This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.
04/2014
Why Might You Need A Ct Scan And An Mri
Sometimes, having both a CT scan and an MRI is recommended.
Although both types of scans can produce detailed, high-quality images of the inside of the body, using both scans in tandem can ensure that nothing is missed when it comes to cancer detection.
In some situations, your doctor may suggest an MRI scan to follow a CT scan if they havent been able to get everything they need from the CT.
MRI scans can also be used to how deep a tumour has grown into body tissues in certain cancers such as cervical or bladder cancer which both typically use CT scans for detection.
MRIs may also be recommended for post-treatment check-ups, to detect whether any tissues left after treatment are cancerous or not.
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Complementary And Alternative Medicine
There is an important distinction between complementary therapies and alternative therapies.
- Complementary therapies, such as exercise and diet changes, are undertaken in addition to conventional medical treatments. Health care providers are often supportive of complementary therapies, depending on your particular situation.
- Alternative therapies are undertaken instead of conventional medical treatments. Some of these may be helpful for some people, but most are not well-studied and none are well-regulated. Misleading websites and false advertising abound. You should be extremely careful about choosing nonstandard treatments instead of treatments that have been evaluated in clinical trials with published results.
Many therapies can fall into either category. Some interfere with standard medical treatment or cause serious side effects, so be sure to inform your doctor if you are considering any of these therapies. Lifestyle changes are likely to be helpful in both reducing the risk of getting prostate cancer and controlling its progression. UCSF is a leader in coordinating clinical trials of diet, exercise and stress in patients with prostate cancer. In addition, every prostate cancer patient treated at UCSF receives access to a nutritionist or dietitian to help in planning a healthy diet and to address dietary issues that may arise during treatment.
African American Men Are Two To Three Times More Likely To Die From Prostate Cancer Than Caucasian Men
Health disparities exist for African American men who have a much higher prostate cancer mortality rate than White men. While you may not be able to control the social or economic drivers of health inequities, you can choose to get informed on the disease and schedule a prostate cancer screening every year to increase your chance of catching it early when itâs easily treated. Pick a consistent time of year every year to schedule your screening, like football season, to help you remember.
African American men are 2-3X more likely to die from #ProstateCancer than Caucasian men. On the blog, find out if and when you may benefit from a #PSA screening test that could save your life: https://bit.ly/3h8gfcx.
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An enlarged prostate can also be the cause of other problems. If the enlarged prostate is causing symptoms, the best treatment would be a natural remedy. In the meantime, there are treatments for a wide range of conditions that cause a man to experience pain. A common surgical procedure involves an electric loop, laser, or electro-stimulation. The procedure is a safe and effective option for treating enlarged or symptomatic BPH.
How Accurate Is A Ct Scan For Cancer
CT scans are very accurate and have a range of benefits. The images that we get from a CT scan are high-resolution and can provide us with lots of useful detail.
CT scans can be used to detect and diagnose cancer, establish what stage a cancer is at, and determine the size and shape of a tumour. They can also be used to establish how close a tumour is to nearby internal organs or structures, check for any nearby blood vessels and help plan effective, successful treatment.
Doctors can also use CT scans to monitor how well treatment is going and in post-treatment follow-ups.
Overall, CTs are considered to be very effective at detecting cancer because they provide accurate, high-quality images quickly.
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Positron Emission Tomography Scan
A PET scan is similar to a bone scan, in that a slightly radioactive substance is injected into the blood, which can then be detected with a special camera. But PET scans use different tracers that collect mainly in cancer cells. The most common tracer for standard PET scans is FDG, which is a type of sugar. Unfortunately, this type of PET scan isnt very useful in finding prostate cancer cells in the body.
However, newer tracers, such as fluciclovine F18, sodium fluoride F18, and choline C11, have been found to be better at detecting prostate cancer cells.
Other newer tracers, such as Ga 68 PSMA-11, 18F-DCFPyl , and Ga 68 gozetotide , attach to prostate-specific membrane antigen , a protein that is often found in large amounts on prostate cancer cells. Tests using these types of tracers are sometimes referred to as PSMA PET scans.
These newer types of PET scans are most often used if its not clear if prostate cancer has spread. For example, one of these tests might be done if the results of a bone scan arent clear, or if a man has a rising PSA level after initial treatment but its not clear where the cancer is in the body. PSMA PET scans can also be used to help determine if the cancer can be treated with a radiopharmaceutical that targets PSMA.
Doctors are still learning about the best ways to use these newer types of PET scans, and some of them might not be available yet in all imaging centers.
Greater Accuracy And Changing Treatment
Approximately 300 men were enrolled in the Australian trial, all with newly diagnosed localized prostate cancer , and all were considered to have high-risk disease. For all men in the trial, the planned treatment was either surgery or radiation therapy to the prostate only.
Half the men were randomly assigned to initially undergo a CT and bone scan, and the other half to PSMA PET-CT.
Based on the imaging, PSMA PET-CT was 27% more accurate than the standard approach at detecting any metastases . Accuracy was determined by combining the scans sensitivity and specificity, measures that show a tests ability to correctly identify when disease is present and not present.
PSMA PET-CT was more accurate for both metastases found in lymph nodes in the pelvis and in more distant parts of the body, including bone. Radiation exposure was also substantially lower with PSMA PET-CT than with the conventional approach.
The trial investigators also tracked how imaging results influenced clinicians treatment choices. Based on imaging findings, the initial treatment plan was changed for 15% of men who underwent conventional imaging compared with 28% of men who underwent PSMA PET-CT.
Another key finding, Dr. Hofman noted, was that PSMA PET-CT was much less likely to produce inconclusive, or equivocal, results .
Thats important, he continued, because if you have a scan with equivocal findings, it often leads to more scans or biopsies or other tests.
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How To Check For Prostate Cancer At Home
How to check for prostate cancer at home
Prostate cancer is only preceded by skin cancer in the leaderboard for causes of cancer among men in the United States. This fact is a solid argument for any man to stay vigilant and consult with doctors at the first sign of a serious condition.
However, what is the red flags that would prompt anybody to make a doctors appointment the following day? This is what we are here to discuss today. Read the following article to gain a better grasp on the symptoms of prostate cancer, how to identify them by yourself, and what treatments you can commence on the spot, right from your home.
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Screening For Prostate Cancer
Prostate cancer is fairly common. Early detection of aggressive prostate cancer may allow timely treatment and can prevent the metastatic spread of cancer cells and death. Many men, especially those at high risk, choose to get screening for prostate cancer. It is important to discuss the risks and benefits of screening for prostate cancer with a urologist to make sure that screening is the right decision for you.
If you decide to get screening for prostate cancer, it is important to decide whether you should have a traditional PSA test or improved modern tests for prostate cancer such as 4Kscore test or PHI .
New York Urology Specialists, under the leadership of Dr. Alex Shteynshyuger, is the first practice in New York City and one of the first in the world to offer 4KScore and PHI test to their patients beginning in 2014.
If youre interested in testing for prostate cancer or prostate cancer screening, please contact New York Urology Specialists for an appointment.
If you have any questions, to schedule a consultation or if you need a second opinion, pleasecontact us or call:
We see patients from all parts of New York City , Long Island, Westchester and New Jersey as well as other parts of the USA. We also see from Canada, Japan, South America, Russia, Asia, Europe, Middle East, Africa, the Caribbean and other parts of the world.
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