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Detection

Prostate cancer doesn't show its face early on, so without symptoms it can be near impossible to detect in the early stages. That is why it is so important to take precautionary measures through early detection to head the disease off at the pass.

Knowledge really is power when it comes to beating prostate cancer. Know your score. Know when a year has passed since your last PSA test and get in the game by getting tested.

How do you assess your risk as a patient? Learn more about Risk Assessment.

Symptoms

There are no noticeable symptoms of prostate cancer while it is still in the early stages. In order to find prostate cancer in its most treatable form, it must be caught before symptoms appear. In more advanced stages, symptoms may include:

• Difficult or frequent urination
• Blood in the urine
• Bone pain

Symptoms should be reported to your doctor, who will then determine if you need to see a urologist. Any change in the:

• Quality or quantity of semen
• Pain on ejaculation
• Loss of potency or libido

should be reported to your primary care doctor. It is also good to report frequent urination at night, difficulty starting or incomplete urinating.

PSA Blood Test

Know your score. The PSA or Prostate Specific Antigen blood test doesn't show whether or not you have prostate cancer- only whether or not you need further testing. The PSA test is still the best option for early detection. Some say that it casts too wide a net, causing too many men to get biopsies or other tests that may be costly or involve pain or risk.

Mortality rates have dropped more than one-third since the PSA test became widely used.

Annual screening should start at age 45 for the general population, but the right age to start PSA testing depends on your level of risk.

Efforts are being made to increase the accuracy of the PSA test and ZERO will award research grants to help scientists work towards developing a more effective test for prostate cancer. In addition, doctors are using new types of PSA tests and new methods to interpret results, in order to better determine who should undergo further testing.

PSA Test Standards

Today, because there are two standards for PSA tests, the same cutoff should not be used across all PSA tests. It is important for you and your physician to know which type of test your clinic's lab uses and how to correctly interpret the results.

The Hybritech PSA test established 4.0 ng/mL as the cutoff for a normal test. This means men with a score above 4.0 should be referred for further testing, such as a biopsy. Men with a result lower than 4.0 may not be referred for biopsy, depending on their physician's instructions. As other manufacturers developed PSA tests, they aligned their tests to the same standard, which became known as the "Hybritech standard," and other manufacturers used the same recommended cutoff of 4.0.

By the mid-1990s, some researchers began to recognize that test results from different test manufacturers could be slightly different and joined together to create a common calibration standard to better align results from different PSA tests. This standard was accepted by the World Health Organization (WHO) and soon became known in the medical community as the "WHO standard" PSA test. To establish this new standard, a different scientific process to measure molecular weight of PSA was used and found that weight to be 20 percent higher than was used for the Hybritech test. Because of the way this is calculated, a WHO test would show a proportionately lower PSA concentration level than would a Hybritech test for the same sample. As a result, the cutoff point at which men are referred for further testing would more appropriately be set about 20 percent lower than the 4.0 used for the Hybritech test.

To find out which type of test you have received, your physician should contact his or her lab to determine which brand of test was used for their PSA testing and whether it is WHO or Hybritech calibrated.

Learn more about the PSA Test.

PSA: There's More to Your Score

Two Types of PSA Tests: Changes in Some PSA Tests May Require Changes in How Results are Interpreted

The PSA (prostate specific antigen) test is one of our best weapons in the battle against prostate cancer, but in recent years, changes to some PSA tests mean some test results may have to be interpreted differently than doctors have become accustomed to. For many years, 4.0 was the cutoff many physicians and medical professionals used for a "normal" test result. But today, a 4.0 isn't always a 4.0 on all tests. Physicians and patients who do not know which type of test was used may not interpret the results appropriately, potentially leading to a delay in care for men with prostate cancer.

It has always been important for men to know their PSA test results and to discuss results with their doctors; now they also need to identify which test they had to ensure that the appropriate interpretation is made.

More Information on PSA Standardization

DRE or Physical Exam

The Digital Rectal Exam (DRE) is a quick and painless physical exam, where the doctor feels for bumps or abnormalities on the surface of your prostate that might be tumor growth. The word "digital" refers to the use of a finger, not a computer. Even if a bump is found, a biopsy is still needed to determine whether it is cancer. Like the PSA test, the DRE doesn't show whether or not you have prostate cancer, only whether or not you need further testing.

The prostate exam, when used with the PSA Test can increase the accuracy for early detection of prostate cancer.

Screening Guidelines

Know when to get tested. The right age to start PSA testing depends on your level of risk:

• Early detection should start at 45 for the general population.
• African-American men or men with one or more risk factors should start annual PSA testing at 40.
• Some men choose to take a single test at an earlier age, 35 or 40, to get a PSA level when prostate cancer is not present and establish a "baseline" level for future comparison.

Men can get their annual PSA test in a variety of locations. ZERO operates the Drive Against Prostate Cancer, which travels the country offering free mobile prostate cancer testing. Check the Drive schedule to see if it's coming to a city near you. If the Drive isn't making a pit stop in your neighborhood, you can schedule a test with your primary care physician, who can do both the PSA test and the physical examination. If you can't afford a doctor visit, call your local hospital or clinic to see if they offer any free testing programs.

Enlarged Prostate or BPH

An enlarged prostate or prostatitis (prostate infection) are common conditions and do not lead to prostate cancer. Almost all men suffer from some prostate enlargement or benign prostatic hyperplasia (BPH) as they grow older.