Particularly affecting men over the age of 50, prostate cancer is generally not an aggressive disease… as long as it is diagnosed! For the moment, there is no medical consensus in favour or against screening. In short, getting screened is a personal matter.
When to start screening for prostate cancer
Screening for prostate cancer is generally carried out from the age of 50. At that age, you are more likely to develop the disease. That’s why prostate cancer screening is recommended at this time.
However, if you have any specific symptoms related to this area, you should consult a doctor as soon as possible (regardless of your age). Prostate cancer can set in long before it becomes apparent. The appearance of symptoms may indicate a more or less serious problem.
Who should I talk to about prostate cancer?
Screening for prostate cancer is a personal matter. There is currently no consensus for or against the practice. So it’s up to you to decide, based on your needs, values and family/medical history. The best thing to do is to talk directly to your GP. He/she will explain all the factors to be taken into account, the procedures and the risks involved.
Alternatively, you can consult a urologist directly, especially if you experience symptoms such as difficulty in urinating, a frequent urge to urinate, pain when urinating, blood in the urine or semen, or pain in the lower back, hips or thighs. Early detection is crucial if prostate cancer is to be detected and treated effectively.
How does prostate cancer screening work?
So, you’ve had a chat with your doctor and you’ve made up your mind: you’re going to have a screening test. The procedure is generally as follows:
First, a blood sample is taken. This is the ‘PSA test’, which shows the protein ‘prostate-specific antigen’ in the blood.
The doctor may also do a rectal examination to see if there is a lump around the prostate, but this is not always indicated.
If your PSA level is abnormal, further tests are required. This is done by taking a biopsy. A biopsy is the removal of a small piece of prostate tissue, which is then analysed to see if there is cancer. If there is cancer, it may be necessary to use imaging to see if metastases have spread. It will then have to be treated using a variety of methods.
Overdiagnosis
A high PSA level does not necessarily mean that there is prostate cancer. To avoid an unnecessary biopsy (which, we agree, is not necessarily pleasant), the size of the prostate must also be taken into account. This is the best way to avoid unnecessary operations.
Over-diagnosis can sometimes lead to the discovery of a tumour, but one that does not bother the patient or affect his life expectancy. As this is not a very aggressive cancer, treatment can sometimes be dispensed with. It all depends on the patient’s age and the risks associated with the stage of the disease.
What are the risks of screening?
Screening for prostate cancer is not dangerous. However, there are a few risks to bear in mind (hence the importance of discussing them with your doctor beforehand): Out of every 100 men who have a biopsy (source: Unisanté):
- around 33 men experience temporary difficulty in urinating or blood in the urine or semen
- 4 men have complications: pain or fever
- 1 man had to be admitted to hospital
To sum up
Screening for prostate cancer is still fairly controversial. In fact, sometimes you can live very well with it, or even not notice it at all. Or in other cases, it can be very disabling. Once again, it’s a personal matter that depends on a multitude of factors. It’s up to you to discuss it with those close to you and your doctor so that you can make an informed decision.
