DIAGNOSING: HOW DO YOU KNOW IF YOU HAVE PROSTATE CANCER?

How do you know if you have prostate cancer? Don’t wait for symptoms to show up, because for early prostate cancer, there aren’t any. By the time a man has noticeable symptoms of prostate cancer, it’s probably too late to cure it. To make matters worse, all of prostate cancer’s symptoms can be attributed to other causes. That’s why the American Cancer Society recommends that, after age 50, men undergo a yearly digital rectal exam and take a yearly PSA test, a blood test that measures levels of PSA (prostate-specific antigen), a key enzyme made by the prostate. Men at higher risk—men who have a strong family history of prostate cancer or who are of African-American heritage—should begin this testing at age 40.

PSA is prostate-specific, not cancer-specific. You can have prostate cancer and still have a low PSA level; about 25 percent of men with prostate cancer do. And, just because you have a high PSA does not necessarily mean you have prostate cancer; many men with high PSA levels don’t. It just means that you have some sort of prostate trouble— maybe BPH, maybe prostate cancer, maybe an infection—and that you should see a urologist to find out what kind of problem you have.

No treatment decision should be made on a lone PSA reading. PSA’s partner in diagnosis must be a digital rectal exam, and then, if either is abnormal, ultrasound and biopsy should be performed. Together, the rectal exam and PSA can do far more than each tactic alone.

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