Prostate screening a key part of men’s health

Your Health Matters
Meritus Health

It’s expected that prostate cancer will be the No. 1 diagnosed cancer in men in the United States this year, according to the American Urological Association. That amounts to 299,010 cases, 6,150 in Maryland.

Prostate cancer is also expected to be the No. 2 cause of cancer deaths among men in the U.S., behind only lung cancer, in 2024. That amounts to 35,250 cases, 660 in Maryland.

“I tell my patients it is so important to weigh the options for screening for prostate cancer, especially if you are at high risk,” said Dr. Kevin Hackett, with Meritus Urology. “Early warning signs are rare with prostate cancer.”

The prostate is a gland in the male reproductive system located just below the bladder and in front of the rectum. It is about the size of a walnut and surrounds part of the urethra (the tube that empties urine from the bladder).

Dr. Kevin Hackett, Meritus Urology

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Dr. Hackett recommends men talk to the doctors about prostate screening at age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years.

Why 10 more years?

Dr. Hackett notes that not all prostate cancers are alike. Finding and treating all prostate cancers early might seem to make sense, but some grow so slowly that they would never cause any problems during a man’s lifetime.

He recommends discussing screening at age 45 for men at high risk of developing prostate cancer. This includes African American men and men who have a first-degree relative (father or brother) diagnosed with prostate cancer at an early age (younger than age 65).

He strongly recommends talking about screening for men aged 40 who are at higher risk: those with more than one first-degree relative who had prostate cancer at an early age.

“When looking at the options, we take the time to review all of the information to make the best decision possible for the patient,” he said. “And screenings aren’t always what the movies would have you believe.”

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Specifically, there is the prostate-specific antigen, or PSA, blood test. The typical test finds a protein made by cells in the prostate gland. The chance of having prostate cancer goes up as the PSA level goes up in the blood. While not 100% effective, the American Urological Association says it should be used as the primary screening.

The other usual test is the digital rectal exam, or DRE, where the doctor uses a gloved and lubricated finger inserted into the rectum to feel for any bumps or hard areas on the prostate that might be cancer. It’s often less effective than a PSA test, but it can sometimes find cancers in men with normal PSA levels.

If a PSA and/or DRE test show signs of cancer, Dr. Hackett said a prostate biopsy might be ordered. That procedure takes a small sample of the prostate using a thin, hollow needle for examination under a microscope. Though more complicated than other tests, it is the only way to know for sure if a man has prostate cancer.

“The doctors at Meritus Urology are there to help men through all stages, from screening to biopsy, to treatment of prostate cancer, should you need it,” Dr. Hackett said. “And you can do things yourself to reduce your risk for prostate cancer, such as exercising, eating healthy, not smoking and limiting alcohol consumption, among other things.”

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