Family Doctor 2007 - (Page 144) men PROSTATE CANCER SCREENING Prostate cancer screening: Is it for you? Prostate cancer follows skin cancer as the most common type of cancer among American men. All men are at risk, but questions about screening remain. Know your risk, watch for signs and talk to your family doctor about your options. By Sarah Smiley Young antigen, or PSA, test. A higher than normal PSA level may mean cancer, but it can have other, less serious causes too. WHAT ARE THE COMMON SYMPTOMS? FREQUENT URINATION PAIN OR BURNING FEELING WHILE URINATING DIFFICULTY STARTING TO URINATE LESS FORCE TO THE STREAM OF URINE DRIBBLING AFTER YOU FINISH URINATING BLOOD OR PUS IN THE URINE PAIN WITH EJACULATION HIP OR BACK PAIN THAT DOES NOT GO AWAY OVER TIME To screen or not to screen? Some doctors think that every man should be screened for prostate cancer once he reaches a certain age. But other doctors don’t think this is a good idea for men who aren’t at higher risk. The American Academy of Family Physicians’ policy states that the choice should be left up to individual men and their doctors. (swelling of the prostate) and prostatitis (inflammation that’s usually caused by infection). But the same symptoms may mean prostate cancer. If you have any of the symptoms listed in the box (right), talk to your family doctor right away. Your doctor can check your prostate by putting a gloved, lubricated finger a few inches into your rectum to feel the gland. This is called a digital rectal exam, or DRE. The doctor is checking to make sure the prostate feels normal, with no bumps or hard spots. These may be a sign of cancer or another prostate problem. M any men — especially those over the age of 50 — have prostate problems. These symptoms may indicate minor problems such as benign prostatic hyperplasia One of the reasons doctors don’t agree about screening is that 3 out of 4 cases of prostate cancer are a slow-growing type, which rarely causes symptoms or any other health problems. Men who have slow-growing cancer can usually expect to live as long as men who don’t have the disease. On the other hand, sometimes prostate cancer is aggressive, which means it grows quickly and spreads early to other parts of the body. In these cases, screening has the potential to catch aggressive cancer at a point that treatment can be life-saving. Weigh the risks and benefits The PSA test is not perfect. Although PSA screening finds many cases of aggressive prostate cancer, it also finds conditions that aren’t cancer. This means that some men may have to go through unneeded tests and worry to make sure they don’t have cancer. Talk to your family doctor about the benefits and risks of prostate cancer screening and treatment. He or she can provide information and advice to help you decide whether or not screening is right for you. Sarah Smiley Young is a senior associate editor with the American Academy of Family Physicians, headquartered in Leawood, Kan. Prostate cancer: Who’s at risk? More than 8 out of 10 men who have prostate cancer are over the age of 65. African-American men are also at higher risk, as are men who have a family history of prostate cancer (especially if their father or brother had the disease). If you’re at higher risk of prostate cancer, your family doctor will probably suggest that Men over the age of 65 are at higher risk of prostate cancer. ADDITIONAL INFORMATION American Academy of Family Physicians http://familydoctor.org/361.xml American Urological Association http://www.urologyhealth.org/adult/index.cfm?cat=09 American Cancer Society http://www.cancer.org/docroot/CRI/CRI_2x.asp?sitearea=&dt=36 National Cancer Institute http://www.cancer.gov/cancertopics/types/prostate you have regular screening. Your doctor may recommend a blood test called a prostate-specific 144 familydoctor 2007 http://familydoctor.org/361.xml http://www.urologyhealth.org/adult/index.cfm?cat=09 http://www.cancer.org/docroot/CRI/CRI_2x.asp?sitearea=&dt=36 http://www.cancer.gov/cancertopics/types/prostate
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