Men’s health has become an increasingly prominent focus in modern healthcare, especially as the medical community continues to prioritize preventative care. Among the most discussed issues in men’s health is prostate cancer screening, an area that remains both crucial and controversial.
Prostate cancer is one of the most common cancers affecting men and is the second leading cause of cancer-related deaths among men in the United States. Despite its prevalence, the approach to screening has been debated due to concerns about overdiagnosis and overtreatment, which can lead to unnecessary anxiety or procedures for slow-growing cancers that may never cause symptoms.
The topic has recently gained renewed public attention following the unfortunate news involving a former U.S. president. While high-profile cases can raise awareness, it’s essential to understand the broader context and guidelines surrounding prostate cancer screening.
Routine screening typically begins with a prostate-specific antigen (PSA) blood test and a digital rectal exam (DRE). Most guidelines recommend initiating screening at age 50 for men at average risk. However, those at higher risk, including African American men and individuals with a strong family history of prostate cancer, may benefit from starting earlier, often around age 40 to 45.
If initial screening results are abnormal, patients are generally referred to a urologist for further evaluation. This may include repeat PSA testing, advanced imaging such as multiparametric MRI of the prostate, or in some cases, a targeted prostate biopsy. These tools help determine whether cancer is present and, if so, assess its aggressiveness.
Treatment strategies are tailored to the severity of the disease. For men with low-risk prostate cancer, active surveillance, which includes monitoring the cancer closely rather than treating it immediately, can be an appropriate and effective option. For those with more aggressive or clinically significant disease, treatments may include minimally invasive surgery or radiation therapy, both of which have seen advancements in recent years.
Encouragingly, prostate cancer mortality rates have declined since the 1990s, likely due to improved early detection and more effective treatment modalities. The most critical factor in achieving successful outcomes remains early detection, underscoring the importance of regular health checkups and open conversations with healthcare providers.
Steven Kardos, MD, is a Urologist with Northeast Medical Group.
