Screening for Prostate Cancer

Introduction

The prostate gland is a gland of the male reproductive system located in front of the rectum, just below the bladder. The prostate gland secretes fluid that makes a part of the semen. The size of the gland is small. As a man grows with age, the size of the gland increases. Sometimes it might block the bladder and obstruct sexual function. In such cases, surgery is needed. This medical situation is called benign prostatic hyperplasia (BPH), and the symptoms are like prostate cancer.

Prostate cancer is a type of non-skin cancer causing more deaths in men than any other cancer (except lung cancer). It is more commonly seen in African Americans than in white men. There is no standard test for screening for prostate cancer. However, some of the commonly done tests are discussed below.

What Is Cancer Screening?

Cancer screening means looking for cancer before the appearance of signs or symptoms. Finding cancer at an early stage provides better chances for successfully treating it. The overall goal of screening is to reduce the number of people who develop the disease, and die from it, and eliminate death rates.

Prostate cancer screening aims to detect cancer at the earliest possible stage before it spreads. If the result of screening tests is found abnormal, then some more tests are done to determine whether an individual has cancer or not. Such tests are called diagnostic tests.

Cancer screening tests include:

• Prostate-specific antigen (PSA) test.

• Digital rectal examination (DRA) test.

What Are the Factors That Increase the Risk of Prostate Cancer?

The following are the main risk factors contributing to the development of prostate cancer:

• Age: As age increases, so does the risk of prostate cancer. After the age of fifty years, the chances of having cancer increase.

• Race: An increased risk of developing prostate cancer is found in black men as compared to whites.

• Family History: Family history and risk of prostate cancer are strongly associated. If any of the father, uncle, or brother was diagnosed with prostate cancer before the age of sixty-five, the chances of getting the disease increase.

• Diet: A diet low in vegetables and fruits and rich in animal fats increases the risk of prostate cancer.

• Genes: BRCA1 and BRCA2 genes are strongly associated with many cancers.

What Is a Prostate Specific Antigen?

Prostate-specific antigen (PSA) is a type of protein secreted by the prostate tissue, a minute amount of which usually enters the bloodstream.

Prostate cancerous cells make more protein than usual, causing an increase in prostate-specific antigen levels in the blood to rise.

Besides the prostate-specific antigen levels, there are other factors to evaluate prostate-specific antigen scores, such as:

• Age.

• Size of the gland.

• Changes in prostate-specific antigenlevels.

• Medications.

How Is Screening for Prostate Cancer Done?

Prostate cancer screening is done to detect evidence of cancer in adults. Two tests are commonly done. They are:

• Prostate-specific antigen (PSA) test.

• Digital rectal examination (DRA) test.

• Prostate cancer gene three (PCA3) ribonucleic acid (RNA) test.

What Is a Prostate Specific Antigen Test?

It is a blood test that evaluates the level of prostate-specific antigen in the blood. The higher the levels of prostate-specific antigen in blood, the higher the chances of getting prostate cancer.

Prostate-specific antigen levels may also be elevated in certain conditions, such as:

• Certain medications.

• An enlarged prostate gland.

• Infection in the gland.

• Certain medical procedures.

Since many factors affect the levels, consulting the doctor and following the advice is the best. If the doctor finds the levels abnormal, they may recommend a biopsy.

What Are the Advantages and Disadvantages of Prostate Specific Antigen Testing?

The advantages of prostate-specific antigen tests are:

• Elevated levels are associated with prostate cancer that is most likely to metastasize (spread to other body parts).

• Early detection and treatment can help cancer before it becomes life-threatening.

Disadvantages of prostate-specific antigen tests are:

• False-positive results due to underlying disease are a significant drawback of these tests. Certain conditions, such as enlargement of the prostate gland or infection (prostatitis), may show higher levels of prostate-specific antigens. Thus false-positive results may come up.

• False-negative results may appear that may result in delays in seeking medical treatment.

• Follow-up tests to rule out the cause of elevated levels may result in more stress, expenses, and time taking.

• This test may find a slow-growing prostate that is not troublesome, and unwanted screening may lead to treatments that are not needed.

• In some cases, finding prostate cancer may not improve a man's health or make him live longer.

• Follow-up tests, such as biopsy, may cause certain complications such as fever, pain, blood in the urine, and urinary tract infection. If the biopsy shows the patient does not have cancer, he might worry more about developing cancer in the near future.

Thus, it is recommended that people with no symptoms, who are expected to live for less than ten years, should not receive prostate-specific antigen screening.

What Is a Digital Rectal Examination?

In this examination, a healthcare worker inserts a well-lubricated, gloved finger into a man's rectum to feel any abnormality or outgrowth. This examination is not recommended due to a lack of evidence, as it is difficult to predict the tumor and its growth.

What Is a PCA3 RNA Test?

A prostate cancer gene three (PCA3) ribonucleic acid (RNA) test is another test used in screening for prostate cancer in some patients. If a man has a higher level of prostate-specific antigen levels and the biopsy report does not indicate cancer and levels remain high, then this test is done. This test measures the amount of prostate cancer gene three (PCA3) ribonucleic acid (RNA) in the urine.

Conclusion

Prostate cancer is one of the most common non-skin cancers affecting older adults. Screening for prostate cancer is done when no symptoms appear. The screening tests include prostate-specific-antigen tests, digital rectal examinations, and ribonucleic acid tests. Diagnostic tests are done when the results of screening tests are found abnormal. Biopsy indicates whether the person has cancer or not. Screening tests should be done in individuals with an average life expectancy of more than ten years.