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A PSA About Getting Your Prostate Checked for Cancer

This common cancer grows slowly, often undetected, which makes prostate cancer screening a critical step for men.

male patient meeting with male doctor Prostate cancer is the no. 1 cancer for men in Iowa — with an estimated 2,050 males developing it in 2019 alone — says the 2019 Cancer in Iowa report. Of those, 350 won't survive.

It's a problem unique to men. Prostate cancer often grows so slowly that you may show little to no symptoms for years. Decades even. But if detected early, you can keep the cancer from advancing to more serious stages. That means doing something uncharacteristic of most men.

Actually going to the doctor and getting a PSA test.

What's a PSA test?

It's not a quiz of your knowledge of that public service announcement about prostate cancer. It's a test to measure the prostate-specific antigens (PSA) in your blood.

PSAs are proteins made by your prostate gland. When there are more of these floating around in your blood, that points to a potential problem with your prostate. Between the ages of 45 and 49, you should get a baseline PSA test. If your levels are low, you just have to check in on your PSA every two to four years — maybe even longer if your PSAs are low enough — until the age of 70. High levels may signal a problem.

However, an elevated PSA does not mean you have prostate cancer.

By itself, a high PSA is just a sign you might have an enlarged prostate, an infection or many other things. Your doctor may order a follow-up blood test to look for cancer or a transrectal ultrasound or MRI to look at your prostate further.

What if my doctor finds prostate cancer?

A cancer diagnosis isn't to be taken lightly, but prostate cancer is treatable. Thanks to the PSA screening, 91 percent of cases are caught when the cancer is still within the prostate or has only spread regionally. And it's successfully treated nearly 100 percent of the time. According to the American Cancer Society, the 10-year survival rate after a diagnosis is 98 percent.

Those are pretty good odds.

Once your doctor finds prostate cancer, they'll figure out how far it's spread by staging it. They take into consideration your PSA levels, as well as:

  • The size of the tumor
  • Whether or not cancer has spread to the lymph nodes
  • Whether or not cancer has moved to other parts of the body through the blood
  • The grade of the tumor — how likely the cancer is to grow and spread quickly

Stages of Prostate Cancer

All that information is placed into a standard staging system to gauge the severity of your cancer. The lower the stage, the better the diagnosis — meaning your prostate cancer hasn't spread very far and it's more treatable.

  • Stage I — The cancer is small, growing slowly and still only in the prostate gland. You're probably not even showing any symptoms of prostate cancer.
  • Stage II — The tumor is larger, but still contained within the gland. It's big enough that your doctor can feel it, and it might be on both sides of your prostate.
  • Stage III — The cancer has spread outside the prostate, but is still close by. It has likely reached the seminal vesicles — the glands that help produce semen.
  • Stage IV — In the most serious stage, cancer has spread throughout the body. By now, it's most likely reached nearby organs like the bladder, rectum or lymph nodes. It may have even reached bones and body parts much further away.

Treating Prostate Cancer

Your stage guides your treatment. And you have to weigh the benefits of each option against the risks and side effects. Your doctor will discuss your options with you to determine the best treatment — not only based on the stage, but also on the risk of your cancer coming back and your overall life expectancy.

Stage I

When your cancer is small and growing slowly, you may take a wait-and-see approach before pursuing other treatments. Watchful waiting is more common in older men; active surveillance in younger and healthier men. Radiation therapy or radical prostatectomy — removing the entire prostate and surrounding tissue — may be necessary.

Stage II

Left untreated, stage II prostate cancers are more likely to spread. If you have no symptoms, active surveillance might be the first step. But radiation therapy and radical prostatectomy may be appropriate. Your doctor may also recommend hormone therapy to try and shrink the cancer or stop its growth.

Stage III

At this stage, cancer is more likely to come back after treatment. Radiation therapy, radical prostatectomy and hormone therapy are your options, with active surveillance to follow.

Stage IV

Curing this stage of prostate cancer is rare. It has simply spread too far. But you can still treat it with radiation or hormone therapy to stop the cancer from spreading further and improve your quality of life. With the cancer more widespread, you'll also be treated to manage your symptoms and relieve pain.

Is there any way to prevent prostate cancer?

Not really. There are no clear causes or proven prevention strategies to stop prostate cancer from occurring. The older you get, the more likely you are to develop it. African Americans and people with a family history of prostate cancer are also more likely to get it.

Diet is the only other known risk factor and the only one you can control. If you eat a diet high in fat, specifically animal fat, you're more likely to get prostate cancer. So stick to a healthy diet to lower your risk, one that includes:

  • Low-fat or reduced fat options — Choose lean meats and low-fat dairy products. Or reduce your consumption of meat and dairy altogether.
  • Lots of plants — Use plant-based oils like olive oil in cooking. Eat more fruits and vegetables.
  • Fish — Eat salmon, tuna and other fish that contain omega-3 fatty acids, which have been linked to a reduced risk of prostate cancer.

Obesity is a problem related to diet, so it's no surprise that you're more at risk of prostate cancer if you're obese. Dietary changes and exercise will help you maintain a healthy wait and lower your risk.

If you read all these risk factors and thought, "Uh-oh. I think I might have a high risk," then talk to your doctor about getting tested for prostate cancer and assessing your personal risk of developing it in your lifetime.

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