Prostate cancer: What you should know

What is the prostate?

The prostate gland (which only men have) is located below the bladder and in front of the rectum. It normally is about the size of a walnut and plays a crucial role in the male reproductive system by producing fluid that nourishes and transports sperm. It can grow larger with age, and the risk of cancer in this gland increases over time.

Detecting prostate cancer

There are several tests used to discover prostate cancer. The most common is a simple, initial blood test called a prostate-specific antigen (PSA) test. If the PSA is elevated, it could mean a man has prostate cancer. However, an elevated PSA can be due to noncancerous conditions as well. In addition to the blood test, some clinicians will perform a digital rectal exam (DRE) to feel for abnormalities in the size, shape or texture of the prostate.

If cancer is suspected, further tests may be recommended. These include a prostate biopsy, where small samples of prostate tissue are removed and examined under a microscope to detect cancer cells. If the cancer is suspected of having spread beyond the prostate gland, other tests such as an ultrasound, MRI or CAT scan might be performed to guide treatment.

Should I be screened?

The U.S. Preventive Services Task Force recommends that for men aged 55 to 69 years, the decision to undergo periodic PSA-based screening for prostate cancer should be an individual one. Men should discuss with their clinician the potential benefits and harms of screening to decide on the best course for them.

Screening offers a potential benefit of reducing the chance of death from prostate cancer and also might find some less-aggressive prostate cancers that may not require surgery, radiation therapy or hormone-blocking drugs. Your clinician should help you determine the best course of action if screening indicates cancer. Surgery to remove the prostate may result in a cure, but it can also interfere with bladder control and sexual function.

The task force does not recommend prostate cancer screening for men aged 70 and older, but there may be individual circumstances when screening an older man is appropriate. If you are age 70 or older, discuss the appropriateness of screening with your clinician.