The importance of prostate cancer screenings

The American Cancer Society estimates that 1 in 8 men will be diagnosed with prostate cancer. Thankfully, prostate cancer is very treatable when it’s caught early.

Sandip Prasad, MD, Vice Chair of Urology and Surgical Director of Genitourinary Oncology at Atlantic Health Morristown Medical Center, shares why prostate cancer screening is important, when to begin and how genetic testing can guide treatment for men diagnosed with the disease.

What is a prostate cancer screening?

Dr. Prasad explains that an annual prostate cancer screening is fast and easy. While many men are concerned about having a digital rectal exam (DRE), it takes only two minutes or so to complete and it gives doctors information about the health of your prostate. Screening also includes a simple prostate specific antigen (PSA) blood test, which measures a protein in your bloodstream that helps assess for the presence of prostate cancer. The test is typically done once a year, but Dr. Prasad says that if your result is lower, you might need the test once every three or even five years. If your PSA levels are high, your doctor might order additional tests such as an MRI or other urine or blood tests to determine the cause. An elevated PSA level doesn’t always indicate that you have prostate cancer.

How often are prostate biopsies needed?

Previously, a patient with a high PSA level would typically have a prostate biopsy done in a doctor’s office. Thanks to noninvasive tests such as prostate MRI or urine-based tests that look at prostate cancer risk, many biopsies can now be delayed or avoided. Atlantic Health is a leader in prostate MRI and is also home to the first MRI-fusion biopsy program in New Jersey.

“Prostate MRI provides roughly 2,000 pictures of an organ that’s about the size of a plumb,” says Dr. Prasad. “It gives us an incredibly precise way to find any areas we should biopsy.”

Is prostate cancer treatable if it’s caught early?

Due to advanced prostate cancer screening methods, men are now diagnosed and treated earlier than a generation ago. Dr. Prasad says that even for men with advanced disease, treatments can extend their lives for many years.

How is prostate cancer treated?

According to Dr. Prasad, the two mainstays of treatment have historically been radiation and surgery.

“That is how about 95% of men in the United States have been treated for prostate cancer for the past five decades,” he says. “Today, for surgery, robotic proctectomy  is the standard of care with focal therapy being an option for selected patients as well. Atlantic Health has been a leader in both focal therapy and robotic surgery. Typically, for these surgical procedures, patients go home the same day they have their surgery and need only over-the-counter pain relievers.”

Who is at risk for prostate cancer?

The risk of developing prostate cancer increases with age. This is especially true for men over 40 who have a family history of prostate cancer in a first-degree relative and men over the age of 45 who have a family history of other hormonal cancers such as breast cancer or ovarian cancer.

“We're learning that if a man’s mother had breast cancer or ovarian cancer, there could be a hormonal link to prostate cancer,” says Dr. Prasad. “It turns out that prostate cancer is in a family of hormonal cancers. Having a mother with a history of ovarian cancer in her forties is important for a man to be aware of and could indicate he needs to come see us sooner.”

How does genetic testing affect prostate cancer treatment?

Genetic testing can indicate whether your prostate cancer requires treatment or is safe to observe with active surveillance.

“When we talk about active surveillance , my  goal is at least 10 years of deferring prostate cancer treatment.  Roughly 40% of our patients who are newly diagnosed with prostate cancer will go on to active surveillance,” says Dr. Prasad. “That means we’re going to keep a close eye on your prostate cancer and ensure it remains at a similar stage to the initial diagnosis.  We’re going to observe you closely, but you won’t  require intervention today.”

In addition to treatment guidelines, because of the advances in genetic testing, men who have a high risk of developing prostate cancer can be identified and treated earlier than ever before.

Where can I find more information about prostate cancer?

Atlantic Health is a leader in prostate cancer prevention, diagnosis and treatment. Click to learn more about our comprehensive program.