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Prostate Cancer

Screening for Prostate Cancer

While there is some controversy among medical thought leaders on when and how often to screen for prostate cancer, WakeMed’s urology team follows the American Urological Association guidelines as follows:

  • For men under the age of 55 years who are at average risk for prostate cancer, the decision about whether to screen or not should be made after a discussion between the patient and their doctor or urologist. Those who are at higher risk may include men who are African American, and/or those who have a family history of prostate, breast, ovarian or pancreatic cancer.
  • For men between the ages of 55 and 69, AUA recommends shared decision-making between provider and patient — with a full explanation of the potential harms associated with screening and treatment. Ultimately, this decision should be made based on men’s values and preferences.
  • For men over the age of 70, screening is recommended for men who are in excellent health or those whose life expectancy exceeds 10 to 15 years.

Generally, AUA recommends men get screened every two years.

What to Expect from a Prostate Cancer Screening

In most cases, screening for prostate cancer involves two separate tests — a prostate-specific antigen (PSA) test and a digital rectal exam (DRE).  Together these two tests can provide your urologist with the best overall understanding of your prostate health.

  • Prostate-specific antigen (PSA) test:  This simple blood test checks the levels of PSA found in your blood. It’s not a definitive test, though, since an elevated PSA level just increases your chance of having prostate cancer. There is no set PSA number that tells us for certain that a man does or doesn’t have prostate cancer. Normal" PSA levels depend on the patients age, so discussion with your doctor is essential. For example, for a man under 50, a normal PSA should be less than 2. For men between 50-70, A 'normal" PSA should be between 2-4. For men over 70, it depends on many factors and the previous trend of information to determine when additional evaluation is needed. It is also important to know that recent sexual activity, urinary tract infection, or chronic prostate inflammation can all affect the PSA.
  • Digital rectal exam (DRE): In this exam, your urologist will briefly insert a gloved, lubricated finger into the rectum to check the prostate for potential abnormalities such as lumps, bumps or hard areas that could indicate cancer.

 While many primary care doctors are shying away from performing PSA and rectal examination, it can sometimes be up to the patient to advocate for their own health and request these tests to be done.

Abnormal results for either of these tests don’t necessarily confirm that you need treatment for prostate cancer. Because prostate cancer is a relatively slow-growing cancer, it’s not always treated right away. Depending on your health and other risk factors, your urologist may recommend either further testing (such as a biopsy) or a “watchful waiting” approach that may involve future, more frequent screening. 

Prostate Cancer

As mentioned, a prostate cancer diagnosis doesn’t always result in treatment. Sometimes “watchful waiting” is advised. Other times, medical treatment – biopsy, resection or radiation therapy – is recommended.

Patients that opt to treat their prostate cancer with radiation can often face potential side effects because of the proximity of the rectum and the prostate. These unintended damages can include fecal incontinence issues or other longer lasting side effects.

WakeMed Urology offers a minimally invasive procedure which inserts a temporary spacer between the rectum and prostate to protect the rectum from damage during radiation therapy. This can help maintain the function of the rectum for the patient. You can learn more about the SpaceOAR Hydrogel procedure here.

Space OAR

Life After Prostate Cancer

You’ve beaten prostate cancer — now it’s time to embrace your health and live to the fullest. But now that you’re recovered, maybe you’re still not feeling your best in other ways? If so, you’re not alone.

Battling prostate cancer isn’t easy — and it’s not uncommon to struggle even after the cancer is cured. That’s because many of the treatments for prostate cancer leave lasting effects on the urinary and reproductive systems — and in some cases, may even lead to issues like depression/mood disorders and relationship problems.

WakeMed’s urology team is here to support patients who have recovered from prostate cancer &nmash; and to help address any long-term side effects. Our board-certified urologists can help you overcome some of the common downstream effects of prostate cancer, including: