Can prostate cancer be found early?
Sometimes prostate cancer is found because a man goes to his doctor with symptoms. Often, though, it is found by testing men with no signs or symptoms of prostate cancer. This is called screening. The test used most often for screening is the PSA (prostate-specific antigen) blood test. Another test that can help find prostate cancer early is when a doctor checks the prostate with his or her finger (a digital rectal exam or DRE). If prostate cancer is found as a result of either one of these tests, it has probably been found at an early, more treatable stage.
Since about 1990 it has become fairly common for men in the United States to have tests to find prostate cancer early. The prostate cancer death rate has dropped, too. But we do not yet know if this drop is the direct result of the tests or if it might be caused by something else, like better treatments.
There is no question that screening can help find many prostate cancers early, but these tests are not perfect. These tests can sometimes have abnormal results even when a man does not have cancer, or they can have normal results even when a man does have cancer. Uncertain or false test results could cause confusion and worry.
Even if these tests find cancer, they can't tell how dangerous the cancer is. The problem is that some prostate cancers are slow-growing and may never cause problems. But because of screening, many men will be found to have prostate cancer that may never have led to their deaths or even caused any problems. Often these men are treated with either surgery or radiation, either because their doctor can't be sure how fast the cancer might spread or because the man is uncomfortable knowing he has cancer and not having treatment. These treatments can lead to urinary or bowel problems or problems with sex. Doctors and patients are still trying to decide who should get treatment and who can be followed without treatment (called watchful waiting).
Studies are being done to try to figure out if early tests for prostate cancer in large groups of men will lower the prostate cancer death rate and help men live longer. The most recent results from 2 large studies didn't offer clear answers.
Until more is known, you should talk to your doctor about whether or not you should be tested. Things to take into account are your age, your health, and the benefits and side effects of screening and treatment. If you are young and you get prostate cancer, it will probably shorten your life if it is not caught early. But if you are older or in poor health, then prostate cancer may never become a major problem because it often grows so slowly.
What the American Cancer Society recommends
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. They should first get information about what is known and what is not known about the risks and possible benefits of prostate cancer screening. Men should not be screened unless they have received this information.
For more details about the American Cancer Society’s recommendations, see our document Prostate Cancer: Early Detection.
Last Medical Review: 08/27/2013
Last Revised: 02/25/2014