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prostate cancer—checking for signs of the disease when
there are no symptoms—is done with the
digital rectal exam and the
prostate-specific antigen (PSA) test. In the United States, about 16 out of 100 men will get prostate cancer, but only 3 will die because of it. That means about 97 out of 100 men will die of something other than prostate cancer.1
The number of deaths caused by prostate cancer
has dropped over the past 20 years. The decrease has been linked to more cases
of early diagnosis through PSA testing and to better cancer treatment. But it is not yet known if PSA testing actually saves lives or if the benefits of having PSA screening are worth the harms of follow-up tests and cancer treatments.
Finding prostate cancer early leads you to some
big decisions. Most prostate cancer grows slowly. And the side effects of
treatment can change your quality of life—mainly not being able to have an
erection (impotence) and not being able to control urination (incontinence). If
you are older with other serious health problems, these side effects may seem worse than
early-stage cancer that may not grow much during your lifetime. But for active or younger men, treatment may help them live longer.
So before you decide to have a
PSA test, talk with your doctor. Ask about your risk for prostate cancer, and
discuss the pros and cons of testing. Some men will not want to live with the
side effects of treatment. Other men are more concerned about survival. It is
important to learn all you can and talk to your doctor before making a
U.S. Preventive Services Task Force (USPSTF) recommends against routine PSA tests to look for prostate cancer.
The USPSTF found that testing does more harm than good. Men who are tested may end up getting treatment they
don't need, and those treatments can cause other problems. Few, if any, men are helped to live longer by having
For more information, see the topic Prostate Cancer.
Zelefsky MJ, et al. (2011). Cancer of the prostate. In VT DeVita Jr et al., eds., DeVita, Hellman and Rosenberg's Cancer: Principles and Practice of Oncology, 9th ed., pp. 1220–1271. Philadelphia: Lippincott Williams and Wilkins.
September 12, 2012
E. Gregory Thompson, MD - Internal Medicine & Christopher G. Wood, MD, FACS - Urology, Oncology
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