Gopal Gupta, MD, is a Loyola Medicine urologist and an expert in radiology and surgical oncology. September is Prostate Cancer Awareness Month. Dr. Gupta answers common questions about testing for prostate cancer.
Q. I’m confused about PSA testing for prostate cancer and who should or shouldn’t get tested. Can you explain?
A. A prostate-specific antigen (PSA) screening is a blood test used to screen men for prostate cancer. There is some controversy about PSA screening especially as men become older because prostate cancer is often a slow-growing disease and some of the men who are found to have the disease may not require treatment. The American Urological Association recommends that all men over 40 years old with a life expectancy of at least 10 years be screened. PSA screening saves lives and we are now utilizing MRI imaging of the prostate to improve on PSA screening for prostate cancer detection.
Prostate cancer screening can help identify cancer early, when treatment is most effective and can prevent death caused by prostate cancer. And a normal PSA test, combined with a digital rectal exam, can help reassure you that it’s unlikely you have prostate cancer. But getting a PSA test for prostate cancer may not be necessary for some men, and this is where guidelines from various organizations come into play.
Professional organizations that do recommend PSA screening generally encourage the test in men between the ages of 40-75 and in men with risk factors for prostate cancer.
Ultimately, whether you have a PSA test is something you should decide after discussing it with your doctor, considering your risk factors and weighing your personal preferences.
Q. What are the symptoms of prostate cancer?
A. One reason that screening for prostate cancer is so important as a man ages is that localized and curable prostate cancer has no symptoms. A decrease in the force of the urinary stream or other voiding issues are more likely due to BPH (benign prostatic hyperplasia) than prostate cancer. For men with localized prostate cancer and some urination problems, the explanation is that BPH is occurring coincidentally with the prostate cancer.
Men with advanced prostate cancer, however, may have symptoms similar to those of men with BPH, including blood in the urine, painful urination and a decreased urinary flow. Fortunately, with today’s emphasis on screening and early detection, more than 9 in 10 prostate cancers are found in potentially curable stages.
Q. How is MRI being used in detecting prostate cancer?
A. The use of MRI in the detection and treatment of prostate cancer is an active area of research. At Loyola, we are on the forefront of using MRI with ultrasound to help improve our prostate biopsies for cancer detection.
Currently MRI is not widely used as a screening test for prostate cancer. However, MRI has an emerging role in making prostate biopsies more effective in detecting prostate cancer. In addition, MRI can provide the surgeon with important information before prostate cancer surgery
Dr. Gupta sees patients at Loyola Outpatient Center and the Cardinal Bernardin Cancer Center, both on the Loyola University Medical Center campus in Maywood. Loyola urologists are available at several convenient locations.