Prostate exams urged for men 40 and over

First Posted: 9/4/2013

Many of you know that each month the National Health Information Center tries to bring public awareness concerning a specific health-related issue to the forefront, in hopes that it will get people talking about it and hopefully spread information.

Although there are several issues for September, I thought one of the most important might be prostate cancer awareness. Whether you are a male over the age of 35 or you know one, I hope you’ll find this information to be useful.

Recently, a new movement in the education and prevention of prostate cancer has started. It’s called “Zero: The Project to End Prostate Cancer” and its mission is simple. Knowledge is power, screening is key and research is critical. More information can be found at the project’s website at

Your prostate is a gland found just below the bladder and in front of the rectum. It wraps around a tube called the urethra, which carries fluids out of the penis. The prostate gland starts out about the size of an almond, until males reach puberty when it doubles in size.

At about age 45, the prostate often starts growing again and for some men will continue to grow. However, this growth is often non-cancerous and known as benign prostatic hyperplasia, or BPH. You’ve probably seen commercials for the drugs Flomax and Avodart that help men with this problem. If the growth is cancerous, it often starts inside the prostate and may grow to the entire gland and spread outside the gland to other parts of the body.

Now the facts:

— One in every six men will get prostate cancer some time in his life. Nearly 219,000 new cases are expected this year, which is more than breast cancer, and it’s the second-leading cause of male cancer-related death in the United States.

— African-American men are at special risk for the disease, with the highest rate of prostate cancer in the world at one in four men. African-American men are 2.5 times more likely to die from the disease.

— Obesity is a significant predictor of prostate cancer severity. Men with a body mass index over 32.5 have about a one-third greater risk of dying from prostate cancer. Research shows high cholesterol levels are also strongly associated with advanced prostate cancer.

— The chances of getting prostate cancer are one in three if you have one close relative with the disease. The risk is 83 percent with two close relatives. With three, it’s almost a certainty at 97 percent.

There are no noticeable symptoms of prostate cancer while it is still in the early stages. This is why screening is so critical. Every man age 50 or over should resolve to be screened annually. African-American men or those with a family history of the disease should start annual screening at age 40.

With the use of screening, about nine out of 10 cases are found early. Nearly 100 percent of men diagnosed with prostate cancer while it is still in the early stages are still alive five years after the diagnosis. Of men diagnosed in the late stages of the disease, 33.4% survive five years.

A screening doesn’t show whether you have prostate cancer, only whether you need further testing. Your doctor may recommend a biopsy based on your screening results. Prostate cancer screening consists of two examinations, which are often done together to increase the accuracy of diagnosis. These include a blood test that measures levels of prostate specific antigen and a physical exam of the prostate, the digital rectal cxam.

The PSA test is the best option we have for early detection. Mortality rates have dropped considerably since it became widely used. Annual screening should start at 50 for the general population. African-American men or men with one or more risk factors should start annual screening at 40. Some men choose to get a PSA test when prostate cancer is not present and establish a “baseline” level for future comparison.

The digital exam may already be part of your annual physical. The doctor is looking for bumps or abnormalities on the surface of your prostate that might be tumor growth. Most men may be somewhat hesitant about this exam, but if we’re going to encourage the women in our lives to get a mammogram, we need to set an example and get a digital exam.

Mike DeCinti can be reached at