Prostate cancer is an important topic for all men.

There have been screening campaigns in Australia encouraging men to be checked for prostate cancers. Some men are confused and worried about when they should have their first test.

It’s important to understand who is more likely to have the risk of prostate cancer.

Prostate cancer is most common in men aged over 50, with 80 percent of new prostate cancer found in men over the age of 60.

Men who have a father or a brother who has had prostate cancer are at a higher risk of also developing prostate cancer.

There is emerging evidence that there can be increased risk of prostate cancer in the immediate male relatives of a mother or a sister who has had breast or ovarian cancer.

Most prostate cancers found grow very slowly without requiring treatment or surgery. Some forms of prostate cancer can grow and spread quickly. These are frequently found in younger men and there seems to be a connection between the genes associated with breast and ovarian cancer and this type of prostate cancer.

The first port of call for testing for prostate cancer is the digital rectal exam (DRE) aka ‘the finger up the bum’. This is combined with a blood test that checks for prostate-specific antigen, also called PSA testing.

In 80 percent of prostate cancers, there will be a rise in PSA but 20 percent of cancers will not cause a rise in PSA. Because of the position of the prostate, examination with the finger is not able to feel all the prostate. If the cancer is small or out of reach, it can be missed.

If either of these tests come back abnormal, the next step is to have an ultrasound of the prostate and in some cases a biopsy to examine for cancer cells.

Recommendations are that men aged 55 to 70 should consider testing if they’re worried or have symptoms. If you are young and concerned or have a brother or a father who has had prostate cancer, it is suggested you have a PSA test at the age of 40 to help predict your potential risk of developing prostate cancer over the next 25 years.

It is recommended to only do PSA testing on men who have symptoms of prostate problems.

These include needing to urinate frequently; difficulty starting or stopping the urine stream; poor urine stream and bladder emptying; post-urination dribbling.

If you do not have any of these symptoms, current guidelines suggest only getting tested if you are particularly concerned. This is because the risk of harm from testing, ultrasounds and biopsy is high compared to the benefit of early cancer detection.

If you have concerns, your family doctor will be able to help answer your questions.

In summary, the current guidelines suggest waiting till you are 55 before considering prostate cancer screening. Even then, if you don’t have symptoms, it’s unlikely you are at immediate risk. Again, talk to your doctor if you have worries.


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