According to the National Cancer Institute, prostate cancer accounted for nearly 15% of all new US cancer cases in 2023. But when it comes to getting screened, the American Cancer Society recommends having a discussion with your health care provider first to determine if it's right for you.
KBIA's Anna Spidel spoke with Dr. Mark Wakefield from Ellis Fischel Cancer Center about when you should think about having this discussion and what the screening could look like.
Anna Spidel: When should men start thinking about their prostate health?
Dr. Mark Wakefield: Around age 40 you should start thinking about this. And definitely by age 50 you should have a thoughtful discussion about whether prostate cancer screening is right for you.
"What we're talking about when we're talking about screening is in trying to distinguish: are you at risk for a prostate cancer that is a threat to your health? And can we find it at a time before it has metastasized, in which our treatments are highly likely to work and potentially cure you of cancer?"Dr. Mark Wakefield
Anna Spidel: When we're talking about prostate screenings - what does that entail? What does that mean? What does it look like?
Dr. Mark Wakefield: So, for most patients, it is a blood test - the PSA - the prostate specific antigen, which can help identify patients at risk for having prostate cancer. It can also be combined with a physical exam called a digital rectal exam where the prostate is palpated. With an examination, that's - for most patients - not their favorite thing to do. And that's why the blood test is so popular, because it avoids the rectal examination of the prostate.
Anna Spidel: Why are prostate screenings important and useful?
Dr. Mark Wakefield: The PSA, prostate specific antigen, was discovered as a protein in the blood that could be reliably measured, and an elevation of that PSA was associated with an increased likelihood of being diagnosed with prostate cancer. So what we're talking about when we're talking about screening is in trying to distinguish: are you at risk for a prostate cancer that is a threat to your health? And can we find it at a time before it has metastasized, in which our treatments are highly likely to work and potentially cure you of cancer?
"The American Cancer Society recommends that men have a chance to make an informed decision with their health care provider about whether to be screened for prostate cancer. The decision should be made after getting information about the possible benefits, risks, and uncertainties of prostate cancer screening."The American Cancer Society
Anna Spidel: For someone who might be confused or saying, you know, I want to get screened for prostate cancer, but I don't know whether or not it is a good idea for me. What would you say to someone who might be in that scenario?
Dr. Mark Wakefield: So, if a patient is worried about whether they should be screened or not, I think they have two options: just get screened, and then sort out what to do - decide if you're going to be aggressive about the next step and diagnosis. Are you going to be conservative about it and gather more data and not immediately do the next step of prostate biopsy?
Anna Spidel: Is there anything that you think would be important to add to this conversation that we didn't discuss?
Dr. Mark Wakefield: There is no definitive answer to the pros and cons of screening for prostate cancer. And again, my personal opinion is - easier to get screened. Because ultimately, for most patients, the window of opportunity to make a diagnosis for prostate cancer is open for a long period of time. In some ways, the window is not open very large. But the opportunity exists for years for us to make an early diagnosis. We can be deliberate about the next steps. But I totally respect people who decide screening for prostate cancer is not for me.
