June is Men’s Health Month, dedicated to raising awareness about men’s health care and encouraging boys, men and their families to practice and implement healthy life decisions. As men begin to age, they may begin to wonder when is the right time to start screening for certain health conditions, including prostate cancer.
“Over time, recommendations about whether or not to screen for prostate cancer have changed,” explained Dr. Chelsey McNabb-Pender, an outpatient internal medicine physician at ThedaCare-Encircle Health. “Scientific data has not yet clearly proven that the benefits of screening outweigh the potential harms.”
Although the benefits of getting screened seem simple, maybe you’d catch cancer earlier, leading to better outcomes, but there are potential downsides.
“Screening can lead to false positive results that lead to unnecessary biopsies, when a patient didn’t actually have cancer,” Dr. McNabb-Pender said. “There is also a risk of over-diagnosis or over-treatment.”
In some cases, prostate cancer can grow slowly and not lead to death or cause bothersome symptoms, she said. In other cases, the cancer can be aggressive. The American Cancer Society (ACS) notes that for American men, prostate cancer is the second leading cause of death, behind lung cancer, killing approximately one in 41 men. However, the five-year survival rate when the disease is detected early is very high.
Professional medical societies such as the ACS, American College of Physicians, American Urological Association and US Preventive Services Task Force now agree that the best approach to begin screening is a shared decision between physician and patient. These discussions should normally begin for men between the ages of 50 and 55.
African American men and Caribbean men of African descent should discuss with their providers whether to start screening earlier because the disease occurs more often in this population, and often at a younger age. While about one in eight white men will develop prostate cancer in their lifetime, one in seven African American men will develop the disease and are more than twice as likely to die from it.
Also, all men who have had a close relative diagnosed with prostate cancer should tell their doctor.
“If a man has a strong family history of prostate cancer diagnosed at less than 65, earlier screening may be considered,” Dr. McNabb-Pender said. “Other factors, such as a patient’s state of health, will also be taken into account.”
Screening is not recommended for men whose life expectancy is less than ten years, for example.
According to the ACS, the risks of developing prostate cancer can include:
- Age. Six out of ten cases of prostate cancer occur in men over the age of 65.
- Race. More cases occur in African American and Caribbean men of African descent.
- Geography. North American men are among the most at risk.
- Family history. Most prostate cancers occur in men with no family history of the disease, but diagnosis in a close relative – a father or brother – more than doubles a man’s risk.
- Inherited genetic mutations. Mutations in the BRCA1 and BRCA2 genes that are associated with an increased risk of breast and ovarian cancer are also associated with prostate cancer. Men with Lynch syndrome have an increased risk of certain cancers, including prostate cancer.
- Chemical exposures. Some evidence shows a link between firefighting chemicals and prostate cancer, and there may also be a link to Agent Orange exposure.
The primary way providers screen for prostate cancer is through a blood test called prostate-specific antigen, or PSA, screening. Historically, a rectal examination (DRE) as part of the physical examination has been used to screen for prostate cancer. Many professional societies no longer routinely recommend it, only if the PSA level is elevated, Dr. McNabb-Pender said.
“Deciding when to screen for prostate cancer is an important discussion to have with your provider during your annual wellness visit,” she said. “By discussing things together, you can make the best choices for screening in the future.”
For more than 110 years, ThedaCare® has been committed to improving the health and well-being of the communities it serves in northeastern and central Wisconsin. The organization provides care to more than 600,000 residents in 17 counties and employs around 7,000 healthcare professionals. ThedaCare has 180 points of care, including seven hospitals. As an organization committed to being a leader in population health, team members are dedicated to empowering people to live their uniquely best lives. ThedaCare also partners with communities to understand needs, find solutions together, and drive health awareness and action. ThedaCare is the first in Wisconsin to be a member of the Mayo Clinic Care Network, giving specialists the ability to consult with Mayo Clinic experts about a patient’s care. ThedaCare is a not-for-profit healthcare system with a Level II trauma center, comprehensive cancer, stroke and cardiac treatment programs, and primary care.
For more information, visit thedacare.org or follow ThedaCare on social media. Members of the media should call Cassandra Wallace, PR and media consultant at 920.442.0328 or the ThedaCare Regional Medical Center-Neenah switchboard at 920.729.3100 and ask for the on-call marketing person.