Is early prostate testing overkill?

What’s a prevention-minded guy to do?

The debate about the effectiveness of testing for prostate cancer still lingers, leaving prevention-minded guys puzzled about the facts.

And understandably so, according to Matthew J. Fargen, M.D., Norton Community Medical Associates – Fincastle: “It’s a very complicated subject.”

But because it is the most common cancer in men (after skin cancer), screening for it is important to many guys who want to be proactive about managing their health.

“In general, I follow the American Cancer Society guidelines and discuss the screening on a case-by-case basis,” Dr. Fargen said.

The American Cancer Society recommends men who do not have any symptoms begin the conversation with their family doctor at age 50 (or at age 45 if you’re African American). For men who have more than one first-degree relative who had prostate cancer at an early age, screening should begin at age 40.

“Family history does weigh in on this decision, which is still based on the man’s informed personal choice,” Dr. Fargen said.

How often you’re tested depends on your PSA level (determined through a blood test). If it’s higher than the normal range (more than 2.5), you should be tested annually. If it’s in the acceptable range (less than 2.5), the American Cancer Society recommends testing every two years.

Dr. Fargen said the controversy about prostate cancer screenings arose when research showed that early detection of prostate cancer did not seem to reduce the death rate significantly from prostate cancer.

On top of that, cancer treatments among men diagnosed on the basis of screening caused side effects such as problems with urinary and sexual function, in addition to expense and pain.

The American Cancer Society does recommend that all men be tested for prostate cancer for the following reasons:

  • The research is not clear whether benefits outweigh risks.
  • All prostate cancers are not the same.
  • Testing is not perfect.
  • Treatment can have serious side effects.

What all men should do, though, is learn about their personal risk factors for prostate cancer and possible benefits of testing so they can make their own decision with the help of their physician.

Some reasons that may aid in making the decision to be tested:

  • It may give you peace of mind knowing the test results
  • Your family can know if you have prostate cancer
  • You will have a better chance of successful treatment if cancer is found early
  • You may already have some risk factors that increase chances of getting prostate cancer

Dr. Fargen pointed out that the prostate screening debate is a very different subject from actually testing men who have symptoms, such as difficulty emptying their bladder or frequent nighttime urination. Men with symptoms of prostate cancer are referred to a urologist for further evaluation.


Need a family doctor? We can help you find one. Then take a quick online prostate cancer risk assessment to learn about your personal risk factors, print it and take it to your appointment with your physician.

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