Prostate Cancer Screening

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What is Prostate Cancer Screening

Prostate screening involves a blood test to detect the levels of PSA (prostate-specific antigen). However, it can be inaccurate and is now not routinely used.

Men over 50 are more at risk of prostate cancer, so they can request a PSA test on the NHS. Men of any age who are worried or at risk can request a private PSA test. They need to understand the implications of the test results.

An MRI scan is usually offered to men who have a raised level PSA test. If an MRI scan shows a problem, an invasive biopsy may be performed where cells are removed from the targeted area and tested for cancer in a laboratory.

Ramsay offers these tests for prostate cancer including a prostate biopsy which is the only test that will diagnose for sure if a man has prostate cancer.

What is prostate cancer?

Prostate cancer is the most common cancer in men in the UK. It starts in a small walnut-sized gland called the prostate. The prostate gland is part of the male reproductive system. It is found beneath the bladder and above the penis and surrounds the first part of the urethra tube that carries urine from the bladder to the penis. The urethra also carries semen fluid containing sperm.

Cancer of the prostate develops when cells in the prostate grow in an uncontrolled way. It usually develops slowly, without any signs for many years. It may grow too slowly to cause any problems or affect a man’s lifespan. If this is the case treatment is not needed.

However, sometimes prostate cancer grows quickly. This means it is more likely to spread and cause problems. If this is the case, it needs treatment to stop it from spreading.

Symptoms of prostate cancer

Symptoms of prostate cancer do not usually show until cancer grows large enough to put pressure on your urethra.

Symptoms of prostate cancer include:

needing to urinate more often, particularly during the night
having to rush to the toilet
difficulty in starting to urinate, straining or taking a long time while urinating
having a weak flow of urine
feeling that the bladder does not fully empty
blood in urine or semen

As men get older, often their prostate gets larger. This is caused by a non-cancerous condition called benign prostate enlargement. These symptoms may be also caused by benign prostate enlargement.

Additional symptoms that may indicate that the prostate cancer has spread include:

bone and back pain
a loss of appetite and unintentional weight loss
pain in the testicles and erectile dysfunction.

What is a prostate cancer screen and how long does it take?

A prostate cancer screen is a blood test that may help detect early prostate cancer. It is called a prostate-specific antigen (PSA) test and measures the level of PSA in a man’s blood. PSA is made by the prostate and higher levels may be found in men who have prostate cancer.

The test takes about ten minutes. A sample of your blood is taken and sent to a laboratory to measure its PSA level of PSA. This is measured in nanograms (a billionth of a gram) per millilitre of blood (ng/ml). Test results can be available from two days to two weeks depending on where you have the test.

At Ramsay we offer the following tests to detect prostate cancer:

PSA test – blood sample analysis
Digital rectal examination (DRE) – a physical examination of your prostate gland to check for enlargement, tenderness, lumps or hard spots.
An MRI scan - gives doctors a very clear picture of the prostate and nearby areas to help identify and locate signs of cancer. It can be used to guide a prostate biopsy.
A prostate biopsy – is the only way to know for sure if a man has prostate cancer. A core biopsy is often used where a thin, hollow needle is passed through the rectum wall or through the skin between the scrotum and anus into your prostate. The needle removes small samples and is repeated several times. It can also help determine the likelihood of growth and rate of spread of prostate cancer.

When is a prostate screen required and how often?

A prostate screen is not routinely used and is not nationally available on the NHS. If you are over 50, you can ask a GP for a PSA test.

Prostate screening is controversial as results can be unreliable. Raised PSA levels can be caused by other non-cancerous conditions as well as prostate cancer. Therefore, raised PSA levels cannot diagnose whether a man has prostate cancer or not.

How effective is prostate cancer screening?

PSA tests are useful in determining if a man has raised levels of PSA. However, they are unreliable in the diagnosis of prostate cancer. Prostate cancer screening has been shown to reduce a man's chance of dying from prostate cancer but if it was offered to all it may result in men receiving treatment unnecessarily.

The problems are that a PSA test can suggest prostate cancer when no cancer exists. This is known as a false-positive result. It can also miss prostate cancer, with around 1 in 7 men with prostate cancer having normal PSA levels. This is called a false-negative result. Additionally, a PSA test can find both aggressive and slow-growing prostate cancer.

Most men are offered an MRI scan if they have a PSA test that shows raised levels of PSA. An MRI scan can help identify and locate prostate cancer. An MRI scan helps doctors to decide if further tests and treatment are required.

The only way to confidently diagnose cancer is by way of a prostate biopsy where a biopsy sample of your prostate is taken and sent to the laboratory.

What age does prostate cancer start and stop?

1 in 6 men in the UK will get prostate cancer at some time in their lives. It can start at any age but the risk of prostate cancer increases with age, especially after age 50. So, if you are under 50 years old, you have a very low risk of being diagnosed with prostate cancer, but it is possible. Prostate cancer is most commonly diagnosed at 65 years and above. Once started, prostate cancer will not stop. It will continue to grow. It could be fast or most likely slow growing.