The prostate is a small walnut-shaped gland that produces the seminal fluid that carries sperm. As men get older, the prostate may grow larger and cause difficulties with urination or sexual function.

Prostate cancer

Prostate cancer is one of the most common types of cancer in men. It usually grows slowly and in the beginning, remains confined to the prostate gland where it may not cause serious harm. While some types of prostate cancer grow slowly and may need minimal or no treatment, other types are aggressive and can spread quickly. Prostate cancer that is detected early, when it's still confined to the prostate gland, has a better chance of successful treatment. It’s very important to see a doctor for a prostate screening every year.

Prostate screening

Prostate cancer usually develops for a period of time with no symptoms, which is why regular screenings by a doctor are very important. Together, a digital rectal examination (DRE) and a prostate-specific antigen (PSA) blood test offer the best chance of identifying prostate cancer early in its development. Both the DRE and PSA test are very easy to perform, require little time, and are not associated with any significant risks.

To screen or not to screen

There is some controversy over whether or not men should get regular prostate screenings. You could have a high PSA result but not prostate cancer and undergo unnecessary testing. Or you could have a low PSA level and normal DRE but actually have prostate cancer. In this case, you would go longer without needed treatment. In addition, you could have an abnormal PSA or DRE, be diagnosed with prostate cancer and treated, but the disease might never spread fast enough to cause you harm.

The majority of primary care physicians and prostate cancer specialists advise prostate cancer screening because they feel that the huge benefit of detecting prostate cancer early in many men outweighs the disadvantages listed above.

• All men over 50 and men over 45 who have significant risk factors should be screened for prostate cancer.
• Men over the age of 75 and those with significant health problems likely will not benefit greatly from screening because they are more likely to die from a cause other than prostate cancer.

What are the symptoms of prostate cancer?  

• Frequent urination or difficulty holding back urine
• Weak or interrupted urine flow
• Inability to urinate
• Pain when urinating
• Difficulty having or sustaining an erection
• Pain or weakness in the back, hips or pelvis
• Unexplained fever not due to a cold or the flu

Prostate cancer in African American men

• African American men have significantly higher rates of prostate cancer.
• African American men have lower rates of screening for prostate cancer.
• African American men have, on average, more advanced and harder to cure prostate cancer at the time of diagnosis.
• African American men have a higher chance of dying from prostate cancer.  

African American men should:

• Get screened for prostate cancer earlier than the standard guidelines suggest. This means most black men should start prostate cancer screening with yearly PSA tests and physical exams at age 40 – even earlier if a strong family history of prostate cancer exists.
• Be more aware of any symptoms that may signal that prostate cancer or another prostate condition (enlarged prostate) has developed. Urinary symptoms are the most common early symptoms of prostate cancer.
• Talk to male family members about their increased risk of prostate cancer.

Resources

American Cancer Society
The Prostate Net
Prostate.org
Prostate Cancer Foundation