Taking care of seniors involve various preventive measures. One important aspect we consider is male prostate cancer screening.
Although often asymptomatic prostate cancer symptoms include frequent urination, weak or interrupted urine flow, or the need to strain to empty the bladder, the urge to urinate frequently at night, blood in the urine, blood in the seminal fluid, and new onset of erectile dysfunction.
African American men and men with a family history of prostate cancer have higher rates of prostate cancer and related mortality from the disease. For male patients aged 55 to 69, the PSA (prostate specific antigen) blood test has been routinely ordered, however there is controversy with testing results and overdiagnosis. Overdiagnosis involves the diagnosis of asymptomatic cancer that never would have resulted in symptoms or death.
The American Cancer Society has the below recommendations for screening.
• Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years
• Age 45 for men at high risk of developing prostate cancer. This includes African Americans and men who have a first-degree relative (father or brother) diagnosed with prostate cancer at an early age (younger than age 65)
• Age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age)
The digital rectal exam (DRE) may also be performed as a part of screening. The repeat testing frequency or interval is based on various medical factors and should be discussed with your physician. One consensus is not to administer a PSA blood test after the age of 70, if the life expectancy is less than 10 years. This is due to the slow growing nature of prostate cancer that would not affect a man with a less than 10-year life expectancy.
Screening and preventive medical care is paramount in my practice, especially with life expectancy increasing and seniors hoping for a better quality of life, as related to their health and fitness. Male patients aged 55 to 69 and higher risk patients, should work together with their primary care physician on a screening scheduled based on risk factors, most recent guidelines, and any potential symptoms.