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What you should know about prostate cancer screening guidelines & active surveillance

Prostate cancer is the second most common cancer among American men. One in six men will be diagnosed with prostate cancer in his lifetime. But if caught early, prostate cancer is one of the most treatable malignancies.

In most cases, prostate cancer symptoms are not apparent in the early stages of the disease. The symptoms of prostate cancer may be different for each man, and any one of these symptoms may be caused by other conditions. As a result, routine screenings in the form of digital rectal exams (DRE) and prostate-specific antigen (PSA) blood tests are important.

More men are being diagnosed with early-stage prostate cancer since PSA testing began in the late 1980s. The PSA test measures the level of PSA in a man’s blood.

In May, the American Urological Association (AUA) released new recommendations for prostate cancer screening. The association encouraged PSA screening approximately every two years for men ages 55 to 69. However, it advised against routine screening for men ages 40 to 54 years who are at average risk for prostate cancer.

The AUA’s recommendations were based on concerns that PSA test results often lead to unnecessary biopsies and treatment, causing more harm than good in some circumstances. Men who have surgery or radiation therapy for prostate cancer often experience side effects, such as incontinence or erectile dysfunction.

The American Cancer Society (ACS) advises men who are 50 years old or older to talk with their doctors about prostate cancer screening and together make a decision about whether they should be tested. Men with one or more risk factors for prostate cancer should also ask their doctor if they should start regular screening before their 50s.

Active surveillance: The “watch and wait” prostate cancer treatment option

Because prostate cancer can be slow-growing, many doctors recommend active surveillance, a treatment approach during which patients are monitored and tested at regular intervals. Surgery, radiation therapy and other treatments would be considered if the patient develops new symptoms or his tests results change.

Older men are more likely to be candidates for active surveillance because treating them with surgery or radiation has not been shown to help them live longer. The decision to monitor prostate cancer instead of treating it is made between a patient and his doctor.

In general, active surveillance could be an option for patients whose prostate cancer is:

  • Not causing any symptoms
  • Expected to grow slowly
  • Small and contained within the prostate
Keep in mind
  • The National Cancer Institute estimates more than 238,500 men will be diagnosed with prostate cancer in 2013.
  • African American men are approximately 60 percent more likely to develop prostate cancer in their lifetime than Caucasian or Hispanic men.
  • Men with a father or brother who has or had prostate cancer are twice as likely to develop the disease.
  • There are more than 2 million prostate cancer survivors currently living in the United States.
  • According to ACS, the 10-year survival rate for prostate cancer diagnosed at an early stage is 98 percent.
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