opportunity to monitor the progression of the cancer if it is slow-growing instead of getting immediate treatment, which can cause serious side effects and long-term complications.
There are no inherent risks related to screening, but it is important to consider timing when thinking about getting a screening.
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Should you get screened?
PSA screening decisions should be made on a case-by-case basis between you and your doctor. However, because prostate cancer is genetic, you should begin discussing screening with your doctor at 40 if you are Black or have a family history of prostate cancer.
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What to expect from a screening
A PSA will reveal results that will help you and your doctor determine your next steps. For example, if your PSA is elevated, your doctor may recommend a biopsy where tissue will be removed to determine if you have prostate cancer.
There are also many other supplementary tests and considerations that can help you and your doctor decide if a biopsy is necessary, including:
- Digital rectal exam results
- Free PSA test (<10% Free PSA indicates greater risk of having cancer; <25% is concerning)
- PSA velocity or the rate of rise over time (faster increase means more risk)
- PSA density, or the PSA per volume of prostate (higher density means more risk)
- PSA-based markers (e.g., the Prostate Health Index or 4K score)
- Other markers, a urinary PCA3 or SelectMDx test
- Magnetic resonance imaging (MRI) of the prostate
You should discuss these tests with your doctor in order to make a decision that is best for you.
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After a diagnosis of prostate cancer is confirmed, PSA will still be used for monitoring the status of your cancer. The results will depend on how the cancer is managed.
The decision of whether or not you should get a screening will be a tough one, but with the appropriate discussion with your doctor; you will be able to make an informed decision that works for you.
When talking with your doctor remember to discuss the following:
- Your level of risk
- Your overall health
- Your life expectancy
- Your desire for eventual treatment if you are diagnosed with prostate cancer
