We’re talking prostates and THAT test!

Prostate cancer is now the most common men's cancer in Australia. This year, it is estimated that a male has a 1 in 6 (or 17%) risk of being diagnosed with prostate cancer by the age of 85¹ meaning it’s more important than ever to understand the rationale and protocol for prostate cancer testing.

GenesisCare Radiation Oncologist, Associate Professor Alex Tan explains ‘prostate cancer is usually asymptomatic and in most cases is picked up only because of screening.  Urinary symptoms can include frequent urination (especially overnight), slow stream, urgency or burning. Most commonly however these symptoms are related to an enlarged prostate (benign prostatic hypertrophy, or BPH) rather than prostate cancer, so it is not reliable to use these symptoms to screen for cancer.’

‘The most effective way to screen for prostate cancer is to perform a Prostate-Specific Antigen (PSA) blood test every 2 years starting at age 50, particularly if you have a family history or worrisome symptoms. Current guidelines suggest to stop screening once a patient reaches 70, however this is now thought to be outdated and we currently recommend continuing to screen men who have a reasonable expectation of being alive and well otherwise in 10 years.’

‘New tests such as Medicare-funded MRI, PET scanning and newer biopsy techniques mean that diagnosing a prostate cancer is much less invasive than previously.  A patient with a new diagnosis of prostate cancer can have a range of minimally invasive tests which provide information on the likelihood of their cancer causing them issues in the course of their natural life. In many cases, the doctor can safely and carefully observe the cancer without subjecting the patient to unnecessary treatment or excessive risk of the cancer progressing.’

When it comes to testing for prostate cancer, you’ll be pleased to know the first step only involves a simple PSA blood test³. “This test will determine if there are elevated levels of a protein that can indicate prostate cancer. If there are, your doctor will likely recommend a digital rectal exam,” says A/Prof Alex Tan.

If you’ve never undergone a digital rectal examination, then chances are you’ve overestimated how uncomfortable it will be.

What you can expect:  

• Your doctor will ask you to slide your pants down and lay on one side on the examination table. They will usually leave the room or draw a curtain around the table while you do this, so you have plenty of privacy.
• Your doctor will put on a rubber glove and, using lubricant, will insert one finger into the rectum to feel for any abnormalities in your prostate.
• The whole process will last 10-20 seconds at most.

Depending on what your doctor finds, they may recommend further tests, such as an MRI or biopsy.

‘While not all prostate cancers need treatment, an informed decision about whether to treat it can't be made without knowing about its presence. And importantly, finding the aggressive cancers early makes a definite difference in regard to the chance of cure,’ says A/Prof Alex Tan.