Get Screened for Prostate Cancer, Officials Say

Dr. William Tu, assistant director of urology at Kaiser Permanente San Leandro Medical Center, advises men to be screened for prostate cancer, which is highly curable if caught early.

Men of a certain age should get screened against prostate cancer during June, National Men’s Health Month, says Dr. William Tu of the Kaiser Permanente San Leandro Medical Center. But any month is fine as long as it’s soon, he added.

Tu, Assistant Chief of Urology at the center, said men between 50 and 69, and Black men beginning at age 45, need to guard against cancer. It doesn’t have any symptoms in its early stages and is highly curable if caught early while hard to beat once it spreads.

It’s also one of the few cancers to become more common in recent years, while most have declined in prevalence, said Tu.

Women, who don’t have a prostate, should encourage men in their lives to get screened.

“Men don’t always go to the doctor when they should,” said Dr. Tu.

The prostate is a small organ just below the bladder that produces seminal fluid. In many men, it gets enlarged with age, causing urination problems, but that problem, and those symptoms, are unrelated to cancer, Tu said.

Prostate cancer is the second-leading cause of death in men, behind only lung cancer. Dr. Tu said that about one in eight men will get it in their lifetime, and about one in forty will die of it.

A blood test looks for levels of PSA, or prostate-specific antigen. A relatively normal PSA result requires no action but does give your doctor something to compare later tests against, said Tu. A very high level might call for immediate treatment.

If the PSA level is somewhat elevated, but not very high, your doctor will probably want to re-test in several months to check its level then. If it’s still elevated, he or she might suggest a biopsy to look for any cancer present, Tu said.

“However, while some prostate cancer is high-risk, much of the time it’s low-risk, growing very slowly,” Tu said. “Unless you live to be very, very old you’ll probably die of something else.”

Men can choose to live with that low risk and not treat cancer, but Tu said you should talk with your doctor about options, including non-surgical ones if you get that result. If you opt not to treat, your doctor will need to keep even low-risk cancer under “active surveillance” as time goes on, in case that risk changes.

Any high-risk cancer found requires immediate treatment, which can include radiation, surgery, hormone therapy, and chemotherapy. Surgery to remove cancer has become simpler in recent years and is thus easier on patients, who can now often leave the hospital the same day, Tu said.

We do not really know what causes prostate cancer or why its incidence is rising, Tu said. Screenings had dropped around 2012 when concerns were raised that PSA testing was leading to overtreatment. Doctors now interpret PSA results more cautiously and urge all men in the target age range to get screened, he said.