Yes or no
Should I get tested for prostate cancer?
Prostate Cancer can be cured quite easily, but you still have to take an early screening to be on the safe side. The prostatic-specific antigen test, or PSA, allows to detect the illness at an early stage, often in the absence of symptoms, thereby preventing many deaths from advanced and aggressive cancers.
The PSA test is actually used to detect the presence of the prostatic antigen in the blood. When its rate is high, this antigen shows that there is an issue with the prostate, but it does not necessarily mean prostate cancer. While this test is the best to screen prostate cancer at the moment, it is not perfect. On its own, it does not show if it’s necessary to cure a patient nor how to do it.
Before deciding to have a PSA test, ask yourself these questions and discuss them with your doctor, your family, and your friends:
- What are my risks of prostate cancer?
- Would I be reassured if my PSA test results are normal?
- What will I do if my PSA level is high?
- If I am diagnosed with a slow-growing cancer that might not cause me any problems in my lifetime, would I want to undergo a treatment that could have side effects that impact my daily life?
The PSA test is usually offered to any man over 50 years old and with a life expectancy of at least ten years. Moreover, a healthy man, who does not show any symptoms nor family background concerning prostate cancer, has very few reasons to worry and wanting to do a screening. On the opposite, a man at risk, namely with a cancer history or of African ancestry, would probably benefit from having regular screenings and examinations as soon as 45.
Based on the Canadian Urologist Association, screening should be discontinued in men at age 70 with no symptoms; however, for men 70 years of age and older, who are interested and in excellent health, screening may be considered in terms of their health, values, and preferences.
Despite all this, if a cancer is detected with the test, it is possible that physicians decide of not curing the patient, because the illness has not developed enough yet or it evolves too slowly, for example. In these cases, a thorough follow-up is often the best option.
Consequently, the PSA test can be a useful tool to screen prostate cancer quickly and to prescribe the appropriate treatment. However, it is not an absolute reference and men at risk are the ones who should take this test the most. In case of doubt, ask advice to your physician and discuss the advantages and disadvantages of being screened with a PSA test.
Advice from urologists
Three doctors give their opinions
The PSA test is the best test available to screen for prostate cancer, but it is not perfect. It helps to find prostate cancer early potentially prevent death from it, but does not tell us who to treat, how and when. There has been some real controversy lately in the media about the PSA test for prostate cancer. The real problem is not with the PSA test itself. It’s all about what is done with the result.
Testing every male for prostate cancer no matter what age and no matter what their history is not recommended. On the other hand, not testing patients because the test is not perfect also does not make sense. This test is simply not black and white. There are lots of nuances in its results and how to interpret and act on them. Sometimes there is no need to ask for the test: if there is no possibility of treating prostate cancer in an individual who may be of an advanced age and may have other existing conditions, it may not make sense to administer the PSA test.
When the PSA test was first introduced in the late 1980’s, physicians did not have the knowledge that they have today with respect to how to act based on results. Today this test is used judiciously in most cases to the point that we rarely see advanced prostate cancers in an emergency situation. That, in and of itself, demonstrates the value of the test if used properly. And although most patients with prostate cancer are being treated, more and more patients with prostate cancer are being followed without active treatment.
We recommend that you, at minimum, speak to your doctor about the pros and cons of having the PSA test and a digital rectal exam if you are over the age of 50. You may even consider starting to do so at 45 if you have a family history of prostate cancer.
Armen G. Aprikian, M.D., F.R.C.S.C.: Urologist at MUHC, Director, Department of urology, Interim Director, Department of oncology, Professor, Division of Urology at MUHC & Leader of the PROCURE Quebec Prostate Cancer Biobank committee
Fred Saad, M.D., F.R.C.S.C.: Uro-oncologist at CHUM, Professor, Department of surgery, Medical Director, Interdisciplinary Urologic Oncology Group, University of Montreal Endowed Chair in Prostate Cancer Research & Head, Urologic Oncology, CHUM
Luc Valiquette, M.D., F.R.C.S.C.: Urologist at CHUM, Professor and Director, Department of surgery, University of Montreal, Medical Advisor, Clinical information systems & Chair of PROCURE’S Clinical Advisory Council.
All three doctors are members of PROCURE’S Board of Directors.
We are here for you
You have questions or concerns? Don’t hesitate. Contact us at 1 855 899-2873 to discuss with one of our nurses specialized in uro-oncology. They are there to listen, support and answer your questions, those of your family or your loved ones. It’s simple and free, like all of our other services.
Also take the time to visit each of our pages on this website, as well as our YouTube channel, in order to get familiar with the disease, our expert lectures and webinars, our section on available resources, the support that is offered to you, our events and ways to get involve to advance the cause.
Pages that might interest you
Want to know more? Just click on one of the links below.
The latest PROCURE news that might interest
Every week we publish a blog article. Here’s some we chose for you.
The medical content and editorial team at PROCURE
Our team is composed of urologists, nurses certified in uro-oncology with a deep knowledge of prostate cancer and other diseases related to the genitourinary system. Meet our staff by clicking here.
Sources and references
Last medical and editorial review: July 2019
Written by PROCURE. © All rights reserved – 2019