Greater Boston Urology Blog

Advantages and Disadvantages of Prostate Cancer Screening

We know the words "prostate cancer" can be extremely overwhelming for patients and their loved ones.    

We also know that a lot of confusing information exists online, particularly when it comes to who should get screened. This is why we asked one of our wonderful physicians, Dr. Shawn Liu, to sit down for a brief Q&A. Below, he talks about the advantages and disadvantages of prostate cancer screening.

As with all content on our blog, what follows is meant to be educational in nature, not medical advice. Always talk to your doctor about your specific health needs.

First, let's have a brief anatomy lesson: Where is the prostate located and what is its main function? 

DR. LIU: The prostate is a male organ that is located below the bladder and in front of the rectum in the male pelvis. The urethra channel passes through the prostate as part of the urinary tract. The function of the prostate is to produce the majority of the seminal fluid to provide nutrients for sperm. 

What does prostate cancer screening entail? Does a blood test definitively indicate a person has prostate cancer? Or is a biopsy needed for diagnosis? 

DR. LIU: Prostate cancer screening involves both a digital rectal exam and a blood test, specifically a PSA or prostate specific antigen blood test. I explain to patients that a PSA is NOT a cancer-specific test in that the number can be elevated for benign reasons as well. The only definitive test for prostate cancer is to perform a prostate biopsy (i.e., obtain tissue samples from the prostate for analysis). 

Here at Greater Boston Urology, we not only can check a PSA, but we can also run a blood test known as a PHI (Prostate Health Index) score, which is another test we can utilize to risk-assess a patient for prostate cancer. This specialized blood test can only be drawn at our GBU offices and is not typically offered at a primary care physician's office.  

If your PSA blood test comes back elevated at your primary care physician's office, it is important to see a urologist at one of our offices for a prostate exam and further blood work to determine a need for a prostate biopsy. 

What are the advantages of prostate cancer screening? Are there any disadvantages? 

DR. LIU: Certainly, the biggest advantage to prostate cancer screening is to diagnose prostate cancer at an earlier stage. This way a patient can be steered towards his most advantageous treatment pathway taking into account all the negatives and positives of the patient's overall health, life expectancy, and treatment risks/benefits.

The disadvantage to prostate cancer screening mainly centers around the biopsy procedures that patients would need to undergo to diagnose prostate cancer. Biopsies have inherent risks, including bleeding and infection. However, here at Greater Boston Urology, we use the latest ultrasound technologies and infection preventing techniques, such as rectal PCR testing, to ensure that these rates are very low. Most patients whom I have performed prostate biopsies on tell me after the procedure that the biopsy procedure was not as uncomfortable as they had imagined.

How do you guide patients regarding when to get screened? Who should get screened, when, and how often? 

DR. LIU: If patients have a family history of prostate cancer, then they should most certainly be screened. In addition, African American patients also have an increased risk of prostate cancer based on race. Any patient with these risk factors should have at least a prostate exam and a PSA blood test once a year starting at age 40 done by their primary care physicians. Any patient with average risk factors should be screened starting at age 45.

Do you have more questions regarding prostate cancer screening? Let us help! 

We have many convenient locations in Eastern Massachusetts, including the Cape. Consider making an appointment with one of our urologists.

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