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For the prevention of most cancers, regular screening is encouraged. But a local doctor says that in the case of prostate cancer, screening can present more inconveniences than benefits for the general population of men.
Dr. Phil Agent, Certified Internal Medicine Physician on the Mercy Fort Smith Board of Directors, says that when it comes to prostate cancer screening, men should not necessarily continue to screen for prostate cancer except where there is a clear reason.
Some of the obvious reasons for screening include an African American man or a man with a family history of prostate cancer, the officer said. These factors place men in a high-risk category for cancer development. Screening is also recommended for men aged 55 to 70 years.
But, for an average man younger than 55 and over 70, a prostate specific antigen (PSA) test – the most common test for prostate cancer – may not be necessary.
"Screening only makes sense when the pre-test probability (of having cancer) is significant," the officer said. "We have to do the test on someone who is probably positive."
According to information from the Mayo Clinic, screening for prostate cancer is a blood test that checks for the presence of an antigen released into the blood and produced by benign and cancerous prostate tissue. A high level of PSA may indicate, but not always, prostate cancer.
The agent said that there are a number of other factors that can elevate PSA levels in men, including infection, sexual activity and l? physical activity, among others. Thus, screening when the man does not suffer from prostate cancer can lead to a false positive, which can lead to unnecessary and expensive additional medical tests. It can also elevate the stress level of the patient who may become anxious about the test results.
Men who do not have a high risk of prostate cancer, and not in the recommended age range for screening, should understand that if they choose screening, a high PSA level does not constitute necessarily a reason to panic.
"If you have a prostate, you are going to have a PSA level," said the officer. Therefore, examining the change in this level over time is the best measure of whether additional action needs to be taken.
The agent added that for men whose high rate of PSA may indicate that they have prostate cancer, not having this information can sometimes prove to be beneficial.
"Not knowing the answer is often better than knowing," said the agent.
Prostate cancer is a unique cancer because of its likelihood of slow growth, the agent said. Because of his increasingly slow nature, he said that the problem is often that it is less clear what to do for something that may not be life threatening, but remains a cancer.
"You do not have to do anything right now," he says.
However, the agent said that he did not advocate "doing nothing". When treatment is not the best option immediately, he said that PSA screening and follow-up points with follow-up tests will allow the patient to make an informed decision. this is the right time to continue treatment.
The officer warned that not all cases are the same and that the disease can range from a non-aggressive stage 1 disease to a very aggressive tumor. There are different variants of the disease depending on how people respond to it.
The two most common treatments for prostate cancer are robotic surgery and androgen deprivation therapy. Agent said that both have consequences that affect the quality of life.
Robotic surgery is usually performed when the cancer is confined to the prostate, while antiretroviral therapy is usually used in more advanced cancers. While men can retain their sexual functionality after robotic surgery, there is still a risk of sexual and urinary dysfunction, the officer said. It is less likely that they retain the functionality being ADT processed, he added.
Men should not use recognition symptoms to screen for prostate cancer, as there is usually none, the officer said. A man usually experiences symptoms that accompany prostate cancer only after developing advanced disease.
The officer said it was best to look individually at men under 55 and over 70 to decide if screening was the best. But as a rule, most patients outside the recommended age range for testing and without high risk should not be tested.
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