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Prostate Cancer Symptoms and Screening

Prostate cancer has no symptoms in the early stages - that's why screening is critical to early detection.

Know your level of risk. Know when to get screened. Start talking to your doctor about it now.

In this section: Screening Overview Risk Factors PSA Test Risk Assessment Prostate Exam Diagnosis: Biopsy Enlarged Prostate Magnetic Resonance Imaging

On this page:

• What are the symptoms?
• What are the risk factors?
• How do you get screened?
• When should you get screened?
• Where do you get screened?
• How is prostate cancer diagnosed?
• What is an enlarged prostate?

Symptoms

There are no noticeable symptoms of prostate cancer while it is still in the early stages. In order to find prostate cancer in its most treatable form, it must be caught before symptoms appear. In more advanced stages, symptoms may include difficult or frequent urination, blood in the urine or bone pain.

Symptoms should be reported to your doctor, who will then determine if you need to see a urologist. Any change in the quality or quantity of semen, pain on ejaculation, loss of potency or libido should be reported to your primary care doctor. It is also good to report frequent urination at night, difficulty starting or incomplete urinating.

Risk Factors

Risk of prostate cancer increases with age. Prostate cancer is rare for men under the age of 40, and most cases occur in men over the age of 65.

Men with a father or brother with prostate cancer are 2x as likely to get the disease. Men with 3 relatives diagnosed with prostate cancer are almost guaranteed to get it.

African American men have a 60% higher risk of getting prostate cancer than white men, and 2x the risk of dying from it. Hispanic men have a risk of getting prostate cancer similar to the general population, but rates of death due to the disease have not declined over recent years as they have for Caucasian and African American men.

Veterans of Asian Theaters (Vietnam and Korea) who were exposed to Agent Orange are at increased risk.

Obese men those with a body mass index of over 32.5 - are 33% more likely to die from prostate cancer if diagnosed.

• Veteran's and Prostate Cancer
  NPCC | www.FightProstateCancer.org/library/2007_Veterans.pdf
• Health Care Benefits for Veterans Exposed to Agent Orange
  NPCC | www.FightProstateCancer.org/libary/VA_benefits.doc

Risk Factors

Screening

Talk to your doctor about screening for prostate cancer.
Screening doesn’t show whether you have prostate cancer, only whether you need further testing. Your doctor may recommend a biopsy based on your screening results.

Prostate cancer screening consists of two examinations:

• A blood test that measures levels of Prostate Specific Antigen or PSA
• A physical exam of the prostate, the Digital Rectal Exam or DRE

These exams are done together to increase the accuracy of diagnosis.

The PSA test is the best option we have for early detection. Mortality rates have dropped considerably since it became widely used. Doctors are working on ways to make the test more accurate and to better understand the results.

Doctors are looking at the level of PSA in your blood and how much it changes from year to year. The National Comprehensive Cancer Network recommends further testing for men with a PSA level of 2.5 nanograms per milliliter (ng/ml) or above.

PSA Test (Blood Test)

The DRE may already be part of your annual physical. The doctor is looking for bumps or abnormalities on the surface of your prostate that might be tumor growth.

Prostate Exam (DRE)

When to Get Screened

The right age to start PSA testing depends on your level of risk:

• Annual screening should start at 45 for the general population.
• African American men or men with 1 or more risk factors should start annual screening at 40.
• Some men choose to take a single test at an earlier age, 35 or 40, to get a PSA level when prostate cancer is not present and establish a “baseline” level for future comparison.

Risk Factors

Where to Get Screened

• The National Prostate Cancer Coalition operates the Drive Against Prostate Cancer, the only national mobile screening program. Visit The Drive’s webpage, and sign up to be notified when it comes to your town.
• Your primary care physician can do both the PSA test and physical examination.
• If you cannot afford a doctor visit, call your local hospital or clinic to see if they offer any free screening programs.

The Drive Against Prostate Cancer

Diagnosis Overview

A biopsy is an analysis of prostate tissue samples taken from the patient. If your PSA levels are above a certain level, or your DRE reveals a potential tumor, your doctor may recommend a biopsy. Most men who undergo biopsies and further testing after a PSA test do not have prostate cancer.

The Biopsy

Enlarged Prostate and Prostatitis

Non-cancerous prostate conditions, such as an enlarged prostate (Benign Prostate Hyperplasia or BPH) or prostatitis are common. They may cause noticeable symptoms, including a rising PSA level. Most men suffer from some prostate enlargement as they grow older.

High grade prostatic intraepithelial neoplasia or HGPIN, abnormal or pre-cancerous cells in the lining of prostate ducts, is a condition very closely associated with high risk for invasive prostate cancer.

Enlarged Prostate and Prostatitis