How Prostate Cancer is Detected and What You Should Know

What is prostate cancer?

Prostate cancer is the second most common cancer in men in the U.S. after skin cancer. It’s mostly found in older men and in most cases, it’s found before it has spread to other parts of the body. Cancer that hasn’t spread tends to be easier to treat and cure.

Cancer is made up of abnormal cells that grow even though your body doesn’t need them. In most cancers, the abnormal cells grow to form a lump or mass called a tumor. If cancer cells are in the body long enough, they can grow to invade or spread to nearby areas in the body.

Who is at risk for prostate cancer?

Robert Wilson, MD, primary care physician at Roane County Family Practice, says, “In the United States, 11 to 13 percent of men will be diagnosed with prostate cancer at some point in their lifetime.”

Male celebrities who have passed away as a result of prostate cancer include Merv Griffin, Frank Zappa, and recently, Dexter Scott King, son of Martin Luther King, Jr. Celebrities who have been successfully treated for prostate cancer include Robert DeNiro, Nelson Mandela, Arnold Palmer and Colin Powell.

Dr. Wilson cites cadaver studies of men who died in their 70s and 80s where sections of the prostate had been removed. The studies found that over 60 percent of the specimens had prostate cancer to some degree. According to the American Cancer Society, prostate cancer is the second leading cause of male cancer related mortality in the United States with 34,700 deaths estimated in 2023. According to the Centers for Disease Control and Prevention, for every 100 American men, 13 will be diagnosed with prostate cancer and two to three of those will die from the disease. Dr. Wilson notes the instance is about 70 percent higher in African American men.

Who should get screened for prostate cancer?

Dr. Wilson says, “I typically screen men with an average risk at age 50 and every one to two years after that. For African Americans, I recommend they begin screening at age 45. People who have a first-degree relative (such as brother, father or son) diagnosed with prostate cancer before the age of 65 should also start screening at age 45.”

He adds, “For people who have more than one first-degree relative diagnosed with prostate cancer at an early age (younger than age 65), they should consider starting at age 40. Other things to consider would be if someone has a BRCA1 or BRCA2 gene mutation or if they have a familial syndrome that can lead to increased risk of cancers, such as Lynch syndrome. These people need to be screened at an earlier age as well.”

What does a prostate cancer screening involve?

“A prostate cancer screening typically involves a prostate specific antigen (PSA) blood test and digital rectal exam,” says Dr. Wilson. “Even though organizations disagree about the utility or effectiveness of prostate screening tests, they all agree that patients and doctors need to have a frank discussion about cancer screening and the pros and cons of testing.”

“There does seem to be a consensus among the organizations that have guidelines regarding prostate cancer screening: physicians and patients should have a frank discussion about the pros and cons of prostate cancer screening.”

How rapidly does prostate cancer grow or spread?

Prostate cancer tends to grow slowly. This means it’s often found and can be treated while it’s still only in the prostate. In fact, some prostate cancers may not need to be treated right away. They can be watched and then treated if they start to grow.

If prostate cancer isn’t treated and grows, it can spread into other parts of the prostate. Over time, it may grow outside of the prostate and into nearby tissues, like the bladder or colon. When cancer spreads to other parts of the body, it’s called metastasis. Once the cancer has grown outside the prostate, it can spread to nearby lymph nodes, too. If prostate cancer spreads to distant parts of the body, it may spread to the bones or other organs, like the lungs, liver, or brain.

Other types of growths can form in the prostate that are not cancerous; these are called benign growths.

What should male patients ask their doctor?

Dr. Wilson says it is very important for patients to discuss prostate cancer screenings to learn the pros and cons, any risks involved and their risk of developing various cancers with their primary care doctor or urologist.

It is important to understand that benign conditions such as enlarged prostate, prostatitis or infection can elevate the prostate specific antigen.

To find a primary care physician near you, visit CovenantHealth.com/Find-A-Doctor.

Types of Prostate Cancer Screenings (source: National Cancer Institute)

Digital Rectal Exam (DRE) – This is an exam of the rectum. The doctor or nurse inserts a lubricated, gloved finger into the lower part of the rectum to feel the prostate for lumps or anything else that seems unusual.

Prostate-Specific Antigen (PSA) – This is a test that measures the level of PSA in the blood. PSA is a substance made mostly by the prostate that may be found in an increased amount in the blood of men who have prostate cancer. The level of PSA may also be high in men who have an infection or inflammation of the prostate or benign prostatic hyperplasia (BPH; an enlarged, but noncancerous, prostate).

It is important to remember that your doctor does not necessarily think you have cancer if he or she suggests a screening test. Screening tests are given when you have no cancer symptoms. Screening tests may be repeated on a regular basis.

If a screening test result is abnormal, you may need to have more tests done to find out if you have cancer. Talk to your doctor about your risk of prostate cancer and whether you need screening tests.