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Fall 2000 Prostate Cancer: Early Detection Saves Lives QUESTION: When should men be screened? DR. DANNEBERGER: All men older than 40 should have a digital rectal exam (DRE) annually. Currently the American Cancer Society recommends that Caucasian males between 50-70 have an annual blood test called a prostatic specific antigen—more commonly known as a PSA. African-American men should begin PSAs at age 45 because the rate of prostate cancer among African-American men is much higher than for Caucasian men. All men with prostate cancer in their families should begin screening five years earlier. QUESTION: Where are the screenings performed? DR. DANNEBERGER: Primary care doctors can perform DREs and PSAs as part of a routine physical exam (where you should also have your cholesterol and blood pressure checked). If you don't have a primary care physician, get one. QUESTION: Why is prostate screening so important? DR. DANNEBERGER: Prostate cancer is the most common cancer in men. It's the second leading cause of cancer deaths behind lung cancer. As with other cancers the key to cure is early dewtection. Prostate cancer is slow-growing, so for men older than 70, the benefits of screening have not been demonstrated. However, for younger men, prostate cancer must be treated aggresively. Cure rates for prostate cancer caught early are high—around 85 percent. But once the cancer spreads outside the prostate, there is no cure. QUESTION: What happens if a screening detects something abnormal? QUESTION: How is prostate cancer treated? DR. DANNEBERGER: There are a number of curative options for prostate cancer, all with highly positive outcomes when caught early. Surgery, external beam radiation therapy, prostate seed implantation (brachytherapy) and hormonal therapy are the methods most often used to treat prostate cancer. Each patient has a different treatment plan based on his situation. Treatment usually has fairly little impact on the quality of life once treatment is complete. |