Assessing Risk of Prostate Cancer

The prostate is a walnut-sized organ located just below the bladder and in front of the rectum in men. It produces fluid that makes up a part of semen. The prostate gland surrounds the urethra (the tube that carries urine and semen through the penis and out of the body).

Prostate cancer is the most common non-skin cancer among American men. Prostate cancers usually grow slowly. Most men with prostate cancer are older than 65 years and do not die from the disease. Finding and treating prostate cancer before symptoms occur may not improve your health or help you live longer.

Men can have different symptoms for prostate cancer. Some men do not have symptoms at all. Some symptoms of prostate cancer are difficulty starting urination, frequent urination (especially at night), weak or interrupted flow of urine, and blood in the urine or semen.

There is no way to know for sure if you will get prostate cancer. The older a man is, the greater his risk for getting prostate cancer. Men also have a greater chance of getting prostate cancer if they are African-American or have a father, brother, or son who has had prostate cancer.

Two tests are commonly used to screen for prostate cancer. A digital rectal exam is a test in which a doctor or nurse inserts a gloved, lubricated finger into the rectum to estimate the size of the prostate and feel for lumps or other abnormalities. Meanwhile, the prostate-specific antigen (PSA) test measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer. The PSA level may also be elevated in other conditions that affect the prostate.

The Centers for Disease Control and other federal agencies follow the prostate cancer-screening recommendations set forth by the U.S. Preventive Services Task Force, which recommends against PSA-based screening for men who do not have symptoms. Other organizations may have other recommendations.

A PSA test can find prostate cancer earlier than no screening at all. However, the PSA test may have false positive or false negative results. This can mean that men without cancer may have abnormal results and get tests that are not necessary. It could also mean that the test could miss cancer in men who may need to be treated. Talk to your doctor about the right decision for you.