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Prostate Cancer Screening

Upstate offers prostate cancer screenings. For more information or to schedule an appointment, please call 315 464-HOPE (4673) to speak with an Upstate Cancer Center representative.

Prostate cancer is one of the most common cancers in the world. The prostate gland sits below the bladder and is only found in men. Most men with prostate cancer are over 65 years of age, but it can occur in those who are younger.

In its early stages, prostate cancer has no symptoms. It is often a slow growing cancer that may take years to develop. As the cancer gets larger or spreads, it may cause problems. This may include impotence, urinary problems, and pain in the back, hip, or thighs. To help detect cancer in its early stages, a doctor may advise a prostate specific antigen test (PSA) and a digital rectal exam (DRE).

PSA Test

The United States Preventive Services Task Force (USPSTF) recommends that men 55 to 69 years of age talk to their doctors to make a shared decision about whether to have a PSA test. They should discuss the risks and benefits of the test along with the person's family history, race and ethnicity, other health problems, values, and health needs. The USPSTF does not recommend PSA testing for men over 70 years of age.

PSA is made by the prostate gland. A PSA test measures the level of the antigen in your blood. It is done with a sample of blood, which can be taken at your doctor’s office during a routine physical exam. It is normal for healthy males to have some PSA in their blood, but levels sometimes increase when prostate cancer is present. There are also other reasons levels may increase, such as prostatitis or benign prostatic hypertrophy (BPH). BPH is a benign (non-cancerous) prostate enlargement. It is often found in older men. If your PSA increases, your doctor may order more tests.

PSA may also be checked in people who have already been diagnosed with cancer to monitor cancer or find out whether treatments are helping.

Key Points

  • Both benign and cancerous health problems can cause elevated PSA levels.
  • The blood test can only measure the levels, not the cause. More testing would need to be done to find the cause.
  • Prostate cancer does not always raise PSA levels. A test that shows normal levels does not mean that a person does not have cancer. Symptoms common to prostate cancer should not be ignored by people who have had a normal PSA test. This could delay treatment.

Digital Rectal Exam

The digital rectal exam (DRE) may be done during a routine physical exam. The prostate gland lies next to the rectal wall. Normally, it is about the size of a walnut. The doctor will use a gloved finger to feel the prostate through the rectum. This exam is done to find lumps or changes to the prostate gland.

Key Points

  • The DRE may not be able to find out if the lump is cancerous or not. A positive test will lead to more testing.
  • Some lumps may not be found through this exam. Very early stage cancer is hard to detect with a DRE. A clear test (where the doctor does not detect any lumps) may also encourage men to ignore symptoms common to prostate cancer. This could delay treatment.

Next Steps

More Testing

Based on the results of one or both tests, your doctor may advise a prostate biopsy. A needle is used to remove a sample of the prostate. The sample will be sent to a lab to look for cancer cells. A biopsy is the only way to confirm the presence of cancer.

A biopsy does have some degree of risk. It can lead to problems with bleeding or infections. It can also be an uncomfortable process.

Since increased PSA levels do not always mean cancer, some men will end up with biopsies that are not really needed. Any exam for cancer can be stressful. For some people, though, identifying cancer at an early stage can be a life saving step.

Watchful Waiting

Most prostate cancers are slow growing. Some are so slow that men with prostate cancer often die from other causes without knowing they had it. A person's age, cancer risk factors, DRE, and PSA results will all play a role in treatment decisions. One option is to simply wait and monitor changes in the cancer. The PSA levels can be used to track any changes.

Some men may not be comfortable with having untreated cancer. However, cancer treatments have risks of their own. They may cause impotence or trouble with leakage of urine.

Decision Making

The benefit of a screening test is measured through its ability to save lives. While prostate cancer screening remains a debatable issue, some studies found that PSA screening did slightly reduce the death rate from prostate cancer. However, many other studies have not shown this link. Also, research has failed so far to show a link between prostate cancer screening and lower overall mortality in men.

If you are 55 years of age or older, PSA and DRE tests may be offered to you. If you are at high risk for prostate cancer, screening can start even earlier. Talk to your doctor about the test options. Ask about the benefits and risks of prostate screening for you. Family history, race and ethnicity, other health problems, values, and health needs will all play a role in your screening plan.


  • Can prostate cancer be found early? American Cancer Society website. Available at: https://www.cancer.org/cancer/prostate-cancer/detection-diagnosis-staging/detection.html.
  • Prostate cancer. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/prostate-cancer.
  • Prostate cancer screening. EBSCO DynaMed website. Available at: https://www.dynamed.com/prevention/prostate-cancer-screening.
  • Prostate cancer screening (PDQ). National Cancer Institute website. https://www.cancer.gov/types/prostate/hp/prostate-screening-pdq.