Dear NP

Dear NP,

My father had a complicated history of prostate cancer. My doctor told me that having my blood PSA level checked is useless. What health screenings are recommended for prostate cancer, and how often?

Dear Reader,

It’s normal to be concerned about your prostate health when you’ve seen a loved one deal with prostate cancer. The prostate is a small gland in men that produces sperm and semen.

Prostate cancer rarely has any symptoms in the early stages. But in later stages, you may have some of the following symptoms: trouble urinating, slower urine stream, blood in the urine or semen, bone pain, weight loss or erectile dysfunction.

Fortunately, prostate cancer detected early is very treatable and has the best chance of survival.

Prostate cancer risk increases in the following groups: over 50 years old, black, family history of prostate cancer, obesity. But you can reduce your risk of developing prostate cancer with these strategies: eat a healthy diet, get regular physical activity and maintain a healthy weight, talk to your healthcare provider about your risk factors for prostate cancer.

Screening for prostate cancer is controversial. Because prostate cancer is usually slow-growing, some healthcare providers do not see the benefit in screening healthy men without symptoms.

Currently, the United States Preventative Services Task Force, an organization that gives evidence-based recommendations for common health screenings, recommends screening only after discussing the risks and benefits of the test between the patient and healthcare provider.

The risk of false positives and unnecessary biopsy should be considered when deciding on screening. The American Cancer Society agrees with these recommendations.

However, if you have any of the risk factors mentioned above, screening for prostate cancer becomes a higher priority, and you might screen at a younger age. Usually, prostate screening starts around age 50, but men as young as 40 with a family history of prostate cancer are eligible for screening.

Screening for prostate cancer consists of a blood test called a prostate-specific antigen (PSA) and/or a digital rectal exam (DRE). PSA levels less than 4 ng/ml are considered normal.

During DRE, your healthcare provider will feel the prostate gland to ensure it is not enlarged and feels healthy. If these screenings are normal, you can go for about two years before you need to be screened again.

Abnormal screenings will prompt your healthcare provider to recommend further evaluation. You might be advised to have an ultrasound, MRI, or a prostate biopsy.

Deciding on getting prostate screening will depend on several factors, including your willingness to agree to a biopsy if you have an abnormal screening. However, having a close relative with prostate cancer is a risk factor that may put you at a higher risk yourself.

The best way to decide if screening is right for you is to discuss your risks and concerns with your healthcare provider.

Dr. Wesley Davis is an Emergency Nurse Practitioner at Crook County Medical Services District and Coordinator of the Family and Emergency Nurse Practitioner program at the University of South Alabama. He encourages readers to send their questions to [email protected]