Taking the test: Prostate exams are critical for men over 50
Knight Ridder/Tribune Business News
01-30-08
Jan. 29–For men over 50 years of age, the unpleasant prospect of prostate cancer is a fact of life.
While some make the decision to regularly undergo screening, others prefer not to worry about a test some experts say can be inaccurate or unnecessary.
But why all the fuss?
The prostate gland is a small organ in men, located behind the pubic bone, beneath the bladder and above the rectum.
According to the Centers for Disease Control: “Among the leading causes of cancer death in men, prostate cancer is second, behind lung cancer. When compared with all causes of death in men over age 45, prostate cancer ranks fifth.”
The CDC says the average man has about a one in six chance of being diagnosed with prostate cancer and a one in 33 chance of dying from the disease.
To combat the risk, approximately three-quarters of U.S. men over 50 undergo regular prostate exams, most commonly, the prostate-specific antigen (PSA) test and the digital rectal exam.
But some sources believe the tests are an imprecise method of diagnosing prostate cancer, and a cause for unnecessary concern for many patients.
In a 2006 study conducted at several Veterans Affairs hospitals in New England, out of approximately 72,000 men over 50, patients who had been screened for the disease weren’t any more likely to survive then those who were not.
Some doctors have argued the rectal exams can miss cancerous growths, and blood tests for PSAs may not reflect whether a problem exists or not.
Julie Finney, physicians assistant at NeoHealth Tahlequah, says men are better safe than sorry, and regular physical exams — especially the digital rectal exam — can reduce their risk of dying from prostate cancer.
“It’s the only thing that can tell us there is a problem,” said Finney. “A lot of our patients, especially the cash-paying clients, can’t afford the PSA tests. But a digital rectal exam is low cost and is a look at prevention, because we can feel the size and whether the prostate is enlarged, or if there are nodules.”
While the digital rectal exam is the preferred method, Finney said, both tests are meant to work as safeguards and used in conjunction with one another.
“It’s [digital rectal exam] part of a physical exam, just like looking at your eyes or in your ears,” Finney said. “The PSA is something that should be done in addition to. You would send them [the patient] for a PSA to verify if something was found, and if the PSAs are high, then you should probably send them for a biopsy.
“As far as accuracy, if you do an exam and you find an enlarged prostate or nodules that shouldn’t be there, there is an abnormality,” Finney said. “By finding it early, you have the time to get early treatment. I know it’s not a pleasant thing, but it’s extremely important — especially if there is a family history or if they are over 50.”
The good news for many men may be in the form of research findings recently published in the New England Journal of Medicine.
According to the study, American and Swiss scientists have identified several genetic markers that indicate risk factors in men with a family history of prostate cancer.
The new research, however, is acknowledged to be only a small step toward more dependable prostate screening, and men are better off being screened by the conventional method.
“I just think it’s such an easy thing to do once a year. It’s simply a measurement,” said Finney. Learn more
For more information on prostate cancer and screening call 1-800-4-CANCER (1-800-422-6237), or visit the Web site: www.healthfinder.gov and search for “prostate cancer.”
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