Prostate Cancer
Early Detection

The exact causes of prostate cancer are unknown. The risk of developing prostate cancer increases as men age. Ultimately, more than one in nine men will develop prostate cancer during their lifetimes. Men with a family history of prostate cancer and African-American men may also be at an increased risk. As men continue to live longer and healthier lives, prostate cancer will likely become an increasingly common problem in the 21st century.

Help is available. Early detection is the hallmark of successful treatment of prostate cancer. Having regular physical exams and PSA tests will help you and your doctors discover prostate cancer at its earliest stages. PSA is a simple blood test that can be done in most doctors' offices or laboratories. The American Cancer Society recommends that all men should have yearly PSA blood tests and physical exams starting at age 50. Men with close relatives who have had prostate cancer and African-American men should have yearly exams starting at age 40. Because of regular screening, the majority of men are now diagnosed with prostate cancer at an early, curable stage, which is a marked departure from 20 years ago, when most men were not diagnosed until the cancer had already grown and spread to other parts of the body.

PSA stands for prostate-specific antigen. It is a chemical produced only by prostate cells, both normal and cancerous. It can be measured easily in the blood. Your physician must carefully review your PSA results. Traditionally, it had been thought that a PSA of 4 was normal. Doctors now know that a "normal" PSA depends on your age and the size of your prostate, along with other factors. What is a normal PSA for one man may, in fact, be very abnormal for another.

Generally speaking, as men age and their prostates enlarge, the "normal" level for PSA increases. Likewise, for men with prostate cancer, as the amount of prostate cancer increases, the PSA level typically increases. Your physician will typically be alerted when your PSA is above what is expected for your age, or if it shows a significant rise from the previous year. Because not all cancers can be found by an elevated PSA, it is critical to have regular physical exams, to feel for abnormal growths of the prostate.

If your primary care physician detects an abnormal PSA or a lump in your prostate during a physical exam, you typically will be referred to a urologist for evaluation and consideration for a prostate biopsy. This is a simple procedure that can be done in a few minutes in a urologist's office. Typically at least six biopsies are performed, three from each side of the prostate.

These biopsies will be sent to a lab where a physician will determine if cancer is present. If so, the physician will then determine how aggressive the cancer is. A scoring system, called the Gleason score, assigns the cancer a number from 2-10, with 2 being a less aggressive cancer, and 10 being a more aggressive cancer.

If the biopsy shows the presence of prostate cancer, the next step is to determine how much cancer is present and to make sure that it has not spread. The specialists at the Center for Prostate Care will review your PSA blood tests, physical exam findings, and biopsy results. Some simple and painless tests, such as X-rays of the pelvic structures and bones (CT scan and bone scan), can also help make sure there is no cancer that has spread outside the prostate.

Using the above information, doctors can then calculate the likelihood of the cancer being completely confined to the prostate, having spread beyond the confines of the prostate, or having spread some distance to the lymph glands in the pelvis. This information, as well as an evaluation of your overall medical condition and well-being, is critical in determining which treatment options will offer you the best chance for a cure. But remember, it all starts with a PSA blood test and physical exam.

For a referral to a physician who can provide you with these screening tests, call the Baptist Health CARE line at 904. 202.CARE (2273).