Did you know that prostate cancer is the most common type of cancer found in Canadian men, and that 1 in 8 men will develop this illness in their lifetime? The good news is that early detection of this type of cancer is possible thanks to two screening tests.
Digital rectal exam
The digital rectal exam is generally the first method used to detect prostate cancer. This physical exam performed by a doctor is simple and causes little discomfort. After inserting a gloved, lubricated finger in the rectum, the doctor palpates the prostate through the rectal wall to detect any lumps or other anomalies that could be signs of cancer. Although the test is not perfect (particularly because the doctor is unable to examine the entire prostate), it is useful because it allows the doctor to check the area where most prostate cancers develop. Moreover, this exam can sometimes detect cancers even when the level of prostate specific antigen (PSA) in the blood is considered normal.
Another way of detecting prostate cancer is to measure the level of prostate specific antigen (PSA), a protein secreted by prostate cells. It is a simple blood test requiring no special preparation. A high PSA level may indicate cancer. However, PSA levels are not specific to cancer. A high level may also indicate other prostate problems, such as an increase in the prostate’s volume, called benign prostatic hyperplasia, or an inflammation of the prostate, called prostatitis. Plus, some men who do have prostate cancer can have normal levels of PSA.
These tests are often combined to improve the accuracy of the screening process. However, neither test can confirm or refute a diagnosis of prostate cancer. Other tests, such as a transrectal ultrasound or a prostate biopsy are necessary to establish a diagnosis.
Should all men take these screening tests?
Experts generally recommend that men aged 50 and over talk to their GP about whether they should take a prostate cancer screening test. Although the digital rectal exam and the PSA test can detect cancer at an early stage, these tests can also produce false alarms and even lead to unnecessary tests and treatments. So it’s best to talk to your doctor about your personal risk of developing prostate cancer and the advantages and limitations of the screening tests. However, men who have a higher risk due to a family history of prostate cancer and men of African descent should check with their doctor whether they should have these tests done earlier.