Prostate cancer shows a wide spectrum of behavior so screening for it begins with annual check-ups with your doctor. Any changes in your health and well-being should be discussed with your physician. Screening of men 50 and older is currently the only method of determining the health of the prostate gland and is the first step for many men as they may have an enlarged prostate and be symptom free. The American Cancer Society, the American Urological Society, and many medical communities’ experts agree: being informed and in tune with your body is important.
The role of screening is being reevaluated, based in part on cost, potential toxicity of treatment, and the fact that some men do well without treatment. Most physicians begin the conversation with their patients regarding prostate cancer and offer screening at age 50. African-American men, who are at a higher risk of death from prostate cancer than white men should begin screening at age 45. The same is true for any man with a first degree relative who has had prostate cancer. For men with more than one first degree relative with prostate cancer, screening begins at age 40 or even earlier.
Two methods are used: a digital rectal exam (DRE) and a prostate specific antigen (PSA) blood test. The digital rectal exam is done in the primary care physician's office. Because the prostate is so close to the rectum, a doctor can feel it by inserting a gloved, lubricated finger into the anus. Lumps, asymmetries, or an enlarged prostate can be detected this way though some small cancers can be missed. A PSA looks for a protein that the prostate makes. Normal prostate tissue makes a little bit of PSA, but prostate cancer usually makes much more. An elevated PSA may suggest that a malignant tumor is present. False positive tests exist. For that reason doctors really on the combination of a PSA blood test and a DRE. If there is doubt, the physician may recommend a sample of prostate tissue from a biopsy be taken for further study.
The Annals of Internal Medicine, established by the American College of Physicians is now recommending men 75 and older not be screened for prostate cancer.
* Source: http://www.annals.org/cgi/content/full/149/3/185