Prostate Cancer Screening: Do I Need a PSA Test?
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Prostate cancer is one of the most common forms of cancer in the United States.  The American Cancer Society estimates that there are 268,490 men diagnosed with prostate cancer in 2022. Although many men diagnosed with prostate cancer never experience symptoms or need treatment, more advanced cases can be fatal.

The difference in life or death hinges on when the disease is detected. Early detection is key to beating any form of cancer, and a prostate-specific antigen (PSA) test is a simple and quick way to screen for prostate cancer, especially if you have certain risk factors.

What is a PSA test?

A PSA test is a blood test that catches signs of prostate cancer early. It can be completed in your primary care provider's office or at a local lab within 15 minutes, just like any other blood test. You don't need to fast before a prostate cancer screening, but you may want to avoid biking or sexual activity for 24 hours before the test. Most major health insurances cover one annual screening for prostate cancer. If you have urologic symptoms, you may be covered for follow-up tests, as needed.

While the test itself is simple, it's important to have an expert interpret the results because they're not always straightforward. A PSA screening can detect high prostate-specific antigen (PSA) levels, but an elevated level doesn't always mean you will develop prostate cancer. Inflammation or enlargement of the prostate can also cause elevated PSA. If your PSA level is high, you should meet with an experienced urologist to discuss your results and next steps.

A PSA test is key to early detection.

When you get a prostate cancer screening, you increase your chances of catching something early when it's easy to treat. Prostate cancer grows slowly over time, and most men with the disease don't know they have it because they don't have any symptoms.

When it comes to cancer, knowing is better than not knowing, and a PSA test can ensure you receive timely treatment if you need it. Survival rates are high for early-stage prostate cancer, as 95 percent of men who get early treatment are alive at the five-year mark. If you wait to get a PSA test, you increase your risk of allowing prostate cancer to progress. When the disease becomes advanced, the five-year survival rate drops to about 30 percent.

Watch our Facebook Live below to learn more about prostate cancer screenings:

Prostate cancer risk factors may determine when you should get PSA testing.

A risk factor is something that increases the likelihood that you will develop a disease. While every man is at risk for developing prostate cancer, there is a greater chance you will develop the disease if you:

  • Are over 50 years old
  • Are African American
  • Have a family history
  • Carry the BRCA1 and BRCA2 mutations, the same genetic mutation that increases the risk of breast cancer in women
  • Smoke
  • Are obese

Whether you have an average risk or a higher risk, you should talk to your doctor about if and when you need a prostate cancer screening. Men who have a father or brother who was diagnosed with prostate cancer may benefit from a screening every year, starting at the age of 50. If your risk of the disease is considered low, you may only need a prostate cancer screening every other year. You do not need to get a PSA test if you are over the age of 70 or if you have a life expectancy of fewer than 10 years, although it's always best to confirm with your healthcare provider.

African American men are two to three times more likely to die from prostate cancer than Caucasian men.

Health disparities exist for African American men who have a much higher prostate cancer mortality rate than White men. While you may not be able to control the social or economic drivers of health inequities, you can choose to get informed on the disease and schedule a prostate cancer screening every year to increase your chance of catching it early when it's easily treated. Pick a consistent time of year every year to schedule your screening, like football season, to help you remember.

African American men are 2-3X more likely to die from #ProstateCancer than Caucasian men. On the blog, find out if and when you may benefit from a #PSA screening test that could save your life:
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What if my test reveals an elevated PSA level?

If your PSA level is elevated, you should always have a follow-up appointment with your primary care physician. You may also want to consult with a urologist who can provide a second opinion. A urologist is trained to interpret PSA results and can determine if any next steps are needed, such as a biopsy. When you meet with a urologist to discuss your results, you can expect them to:

  • Ask about your medical history
  • Inquire about your family history of the disease
  • Conduct a digital rectal exam
  • Explain the pros and cons of additional screening, if necessary
  • Offer options for next steps

Many men have elevated PSA levels but not everyone needs prostate cancer treatment. Because the disease typically grows slowly, some men benefit from active surveillance.

Treating prostate cancer.

Typically, urologists diagnose prostate cancer after a referral from a primary care provider. Different ages and cancer stages benefit from different treatment approaches, and your doctor will discuss which may be right for you. As one of the most comprehensive prostate cancer centers in the region, we have an experienced multidisciplinary team at your service. We not only offer the full array of treatment options, we’re also leading new discoveries in prostate cancer care that are resulting in excellent prognoses for our patients. Our goal is always to cure your cancer, and we also want to protect your quality of life. We do this by offering a range of treatment options that will achieve the best possible outcome.

In most cases, younger men with a 30-year life expectancy will opt for surgery, which may involve robotic-assisted technology. This minimally-invasive approach involves less pain and recovery time than traditional surgery, but it's only as good as the surgeon using it. When your surgery is performed by an experienced surgeon, your risk of side effects, like incontinence or erectile dysfunction, is much lower. At MedStar Georgetown Cancer Institute, our surgeons have performed over 4,000 robot-assisted prostatectomies, making us some of the most experienced in the region when it comes to treating prostate cancer.

Older men may benefit from radiation instead of surgery. We've pioneered advances in radiation treatment as well, as one of the first in the country to use CyberKnife® radiation to treat prostate cancer. CyberKnife offers many benefits over traditional radiation because it's faster, requires fewer sessions, and is more effective. CyberKnife also treats prostate cancer with millimeter accuracy in just 5 treatments compared to 40 treatments necessary for conventional radiation therapy. 

Prostate cancer care at MedStar Georgetown Cancer Institute.

If you need a second opinion on your PSA level after screening for prostate cancer, you'll benefit from our team approach and broad experience. At the MedStar Georgetown Cancer Institute, our cancer team involves experts from a variety of disciplines, including urologists, medical oncologists, radiation oncologists, and others who work closely together to evaluate which treatment option will benefit you the most. We treat more patients for prostate cancer than most health systems in the region, so you can trust that we have the tools and the experience necessary to care for you.

Don't let the fear of a prostate cancer diagnosis keep you from getting a prostate cancer screening. Talk to your doctor about getting your PSA checked early so that you can seek timely treatment, if necessary, and continue doing the things you love while you're in the prime of your life.

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