Prostate Cancer Screening, Part 1: Everything You Need to Know

Getting screened for prostate cancer might sound a little intimidating, but it’s a vital part of staying healthy as you age. Our team at CIVCO is here to help you prepare.

Aside from melanoma, prostate cancer is the most common cancer ¹ among men in the United States, with about one in eight ² receiving the diagnosis during their lifetime. Thankfully, when detected in its early stages, the five-year survival rate for prostate cancer is higher than 99%. ³ 

Whether you’re about to head in for your first prostate exam or you’re still weighing the pros and cons, we have you covered. We’ll walk you through the basics of a prostate cancer screening so you know exactly what to expect before, during, and after the appointment — and even give you some key questions to run by your doctor while you’re there. 

What Is Prostate Cancer Screening?

In short, prostate cancer screening helps your doctor detect the early signs of prostate cancer and make a treatment plan if needed. ⁴ Screening is a great way to stay ahead of prostate cancer because it’s highly curable when diagnosed and treated early on. ⁵

To give you a better idea of what’s behind the medical terminology — and help you avoid any awkward pauses at the doctor’s office — let’s break down the phrase “prostate cancer screening” one word at a time.

• The prostate is a small, walnut-shaped gland in the male reproductive system. It’s located in the lower part of the pelvis, right below the bladder. Though it serves several functions, the main one is to help make semen, the fluid that carries sperm. ⁶
   
• Cancer is a disease in which cells grow uncontrollably. Normally, our cells grow and multiply in an orderly fashion through a process called cell division. Sometimes, this process breaks down, and damaged or abnormal cells multiply when they aren’t supposed to. When this uninhibited cell growth happens in the prostate, it’s called prostate cancer. ⁷
  
• A screening test is done to detect health disorders or diseases in people who don’t have symptoms. It can help doctors find a problem in the earlier stages when it’s easier to treat. It’s important to note that a screening test does not diagnose a disease — it only tells you whether you might have it. ⁸

So, putting it all together, prostate cancer screening is a type of test that will help your doctor detect early signs of prostate cancer and collaborate with you to find the right next steps.

Before we get into the specifics of the screening itself, let’s address the question that might be lingering in the back of your mind: Do I really need to get screened?

Do I Need a Prostate Screening?

Here’s the fast answer: your decision to get screened should be made in consultation with your doctor. Your doctor is the only one who can review your family and medical history and discuss your personal concerns to help you make the right choice. ⁹

While we can’t give you personalized advice, we can offer some guidance to help you decide. When you’re thinking about getting screened, consider factors like: 

• Your age. Prostate cancer is more common in older men. While the general guidelines recommend starting at age 55, you may benefit from screening as early as age 40 — and it’s never too early to discuss it with your provider. ¹⁰
• Your ethnicity. Ethnicity is a key factor in determining the likelihood of developing prostate cancer and predicting its course. For example, Black men are at an increased risk of prostate cancer. ¹¹
• Your family history. Of all the major cancers, prostate cancer is the most heritable. If you have a close relative with prostate cancer, you’re more likely to develop the disease. ¹²
• Environmental factors. Some studies indicate that men in professions with frequent exposure to certain chemicals (for example, firefighters exposed to combustion byproducts) have an increased prostate cancer risk. ¹³

Prostate Cancer Symptoms

Though the majority of men (94%, according to a recent survey) discover prostate cancer through early screening, some men learn about it because of urinary or erectile symptoms. Here are the main ones to keep an eye out for:

• Difficulty starting urination
• A weak urinary stream
• Frequent nighttime urination
• Pain or burning when urinating
• Pain in the genital and pelvic area
• Pain when ejaculating
• Blood in the urine or semen
• Persistent pain in the back, hips, or pelvis

If you’re experiencing one or more of these symptoms, you should discuss your concerns with your provider. They’ll help you sort out what’s really going on and build a treatment plan to help alleviate your symptoms. ¹⁴

What To Expect from Prostate Screening

Now that we’ve covered the basics, it’s time to prepare for the screening itself. Usually, two simple tests are all that’s required: a PSA Blood Test and a Digital Rectal Exam (DRE).

PSA Blood Testing 

Prostate-specific antigen (PSA) is a protein made by cells in the prostate gland. By measuring the level of PSA in the blood, doctors can estimate the chances that you have prostate cancer and, if needed, recommend additional tests. ¹⁵

In the 48 hours leading up to your PSA exam, you should refrain from sexual activity or strenuous workouts. Each of these can temporarily increase your blood PSA level, which could lead to inconsistencies in the exam results. ¹⁶

Thankfully, the exam itself is straightforward. Your provider will draw a small amount of blood, then send it to a lab for analysis. Your blood PSA level, which is measured in nanograms per milliliter (ng/mL), will help your doctor evaluate the chances that you have prostate cancer:

• A PSA level under 4 ng/mL means you are unlikely to have prostate cancer
• A PSA level between 4 and 10 ng/mL means you have about a 25% chance of having prostate cancer
• A PSA level above 10 ng/mL means that your odds of having prostate cancer are greater than 50% ¹⁷

It’s best to remember that, even though the PSA test is very helpful as an estimate, the exact numbers will vary from person to person. Many factors (including age, prostate gland size, infection, and medication) influence your blood PSA levels — so don’t worry about interpreting your results until you’ve had a discussion with your doctor. ¹⁵

Digital Rectal Exam (DRE)

Usually, a PSA blood test is paired with a digital rectal exam (DRE). DREs aren’t as effective as blood tests, but they can help doctors find prostate cancer even when the PSA test produces normal results, so they’re an important part of the screening process. ¹⁸

During the DRE, a doctor will insert a gloved, lubricated finger into the rectum and feel for any bumps or irregularities in the prostate. While this might be uncomfortable, it isn’t usually painful and it’s over quickly. ¹⁸ Plus, preparation for the DRE is minimal: while you should let your doctor know if you have a condition (like hemorrhoids) that could be aggravated by the exam, there isn’t any special preparation involved in the DRE. ¹⁹

Questions To Ask Your Doctor

Before you head in for your prostate screening, it’s never a bad idea to jot down a few questions. Our team at CIVCO has gathered a few below that might be beneficial for you to ask: 

• How does a PSA blood test work?
• How will I know if my results are normal?
• If my PSA blood level comes back high, what’s next?
• Does a high PSA level always indicate prostate cancer?

Key Takeaways from CIVCO

If you’ve stuck with us to this point, you’re already a budding expert on the topic of prostate cancer screening — but a quick review couldn’t hurt! Before you go, here are the key points to bring with you:

• Prostate cancer is common and, when detected early, highly curable
• Prostate cancer screening helps your doctor detect prostate cancer early and develop a treatment plan if needed
• Your decision to get screened should be made in consultation with your doctor

Introducing TP Pivot Pro:

When preparing for your prostate cancer screening, it’s important to consider all of your options and ask your clinician what prostate biopsy method they utilize. CIVCO’s TP Pivot Pro disposable needle guides are designed to make your biopsy as safe as possible, reducing the number of puncture sites required through the perineum while also helping to lower the risk of infection. 
The transperineal approach is shown to improve access to all zones of the prostate, giving you peace of mind with better detection of clinically significant disease and anterior tumours.²⁰ With reduced risk of rectal bleeding and infection, and potential elimination of antibiotics altogether, consider asking your provider if they offer the transperineal approach as a standard biopsy method in their practice.^{21, 22}

To discover more about how the transperineal approach, when coupled with CIVCO’s TP Pivot Pro disposable needle guides, can make a difference in your prostate cancer screening, check out our website at www.civco.com/tp-pivot-pro, and be sure ask your provider for more information. 

References:

1. CDC: Prostate Cancer Statistics: https://www.cdc.gov/cancer/prostate/statistics/index.htm
2. American Cancer Society: Key Statistics for Prostate Cancer: https://www.cancer.org/cancer/types/prostate-cancer/about/key-statistics.html
3. American Cancer Society: Survival Rates for Prostate Cancer: https://www.cancer.org/cancer/types/prostate-cancer/detection-diagnosis-staging/survival-rates.html
4. American Cancer Society: Can Prostate Cancer Be Found Early?: https://www.cancer.org/cancer/types/prostate-cancer/detection-diagnosis-staging/detection.html
5. Cleveland Clinic: Prostate Cancer: https://my.clevelandclinic.org/health/diseases/8634-prostate-cancer
6. Cleveland Clinic: Prostate: https://my.clevelandclinic.org/health/body/23965-prostate#:~:text=A%20note%20from%20Cleveland%20Clinic,you%20age%2C%20which%20is%20normal.
7. National Cancer Institute: What is Cancer?: https://www.cancer.gov/about-cancer/understanding/what-is-cancer
8. John Hopkins Medicine: Screening Tests for Common Disease: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/screening-tests-for-common-diseases#:~:text=What%20is%20a%20screening%20test,to%20treat%20it%20most%20effectively.
9. CDC: Should I Get Screened For Prostate Cancer?: https://www.cdc.gov/cancer/prostate/basic_info/get-screened.htm#:~:text=Before%20deciding%2C%20men%20should%20talk,screened%20for%20prostate%20cancer%20routinely.
10. John Hopkins Medicine: Prostate Cancer: Age-Specific Screening Guidelines: https://www.hopkinsmedicine.org/health/conditions-and-diseases/prostate-cancer/prostate-cancer-age-specific-screening-guidelines#:~:text=While%20the%20general%20guidelines%20recommend,who%20have%20had%20prostate%20cancer
11. Zero Prostate Cancer: Black/African Americans and Prostate Cancer: https://zerocancer.org/learn/about-prostate-cancer/risks/african-americans-prostate-cancer/#:~:text=Overall%2C%20Black%20men%20are%201.7,prostate%20cancer%20outcomes%20is%20narrowing.
12. Prostate Cancer Foundation: Prostate Cancer Risk Factors: https://www.pcf.org/patient-resources/family-cancer-risk/prostate-cancer-risk-factors/
13. John Hopkins Medicine: Prostate Cancer Risk Factors: https://www.hopkinsmedicine.org/health/conditions-and-diseases/prostate-cancer/prostate-cancer-risk-factors#:~:text=Environmental%20Exposures,are%20exposed%20to%20agricultural%20chemicals.
14. Zero Prostate Cancer: Prostate Cancer Symptoms: https://zerocancer.org/learn/about-prostate-cancer/symptoms/
15. National Cancer Institute: Prostate-Specific Antigen (PSA) Test: https://www.cancer.gov/types/prostate/psa-fact-sheet#:~:text=Prostate%2Dspecific%20antigen%2C%20or%20PSA,to%20a%20laboratory%20for%20analysis.
16. NHS: Why should I avoid sexual activity before a PSA test?: https://www.nhs.uk/common-health-questions/mens-health/why-should-i-avoid-sexual-activity-before-a-psa-test/#:~:text=Semen%20released%20during%20sexual%20activity,remain%20raised%20for%20many%20months)
17. American Cancer Society: Screening Tests for Prostate Cancer: https://www.cancer.org/cancer/types/prostate-cancer/detection-diagnosis-staging/tests.html
18. Giddy: Here’s What a Digital Rectal Exam Is – and Isn’t: https://getmegiddy.com/digital-rectal-exam
19. Cleveland Clinic: Digital Rectal Exam: https://my.clevelandclinic.org/health/diagnostics/24212-digital-rectal-exam
20. Devetzis K. Kum F. & Popert R. (2021). Recent Advances in Systematic and Targeted Prostate Biopsies 799–809. https://pubmed.ncbi.nlm.nih.gov/34805013/ 
21. Panzone J. Byler T. Bratslavsky G. & Goldberg H. (2022). Transrectal Ultrasound in Prostate Cancer: Current Utilization Integration with Mpmri Hifu and Other Emerging Applications 1209–1228. https://pubmed.ncbi.nlm.nih.gov/35345605/
22. Kenton, L. (2019, December 3). In detecting prostate cancer, which biopsy procedure is best? https://physicians.dukehealth.org/articles/detecting-prostate-cancer-which-biopsy-procedure-best