The outlook for prostate cancer can be positive when a person receives an early diagnosis from a doctor. Screening may involve a PSA test, PCA3 test, DME, and additional testing if recommended.
In the United States, prostate cancer is the
If you receive a prostate cancer diagnosis early, the outlook can be positive. Several screening tests are available to help with early detection.
Doctors might use multiple screening tests to detect prostate cancer:
Prostate-specific antigen test
Your prostate makes an enzyme called prostate-specific antigen (PSA) that doctors can detect with a blood test. At-home kits are also available, but know that these may be more prone to human error.
Elevated PSA can be an indicator of prostate cancer. However, high levels can also occur due to noncancerous conditions, so your PSA levels can’t definitively say whether you have prostate cancer.
To complete a PSA test, a medical professional draws blood and sends it to a lab. For an at-home PSA test, you take your sample according to the manufacturer’s directions and then it’s sent to a lab.
Results are usually available after a few days to 1 week. Additional testing might be required if your results are abnormal.
Digital exam
A digital rectal exam (DRE) is a physical examination of your prostate gland.
Using a lubricated, gloved finger, a doctor can directly feel your prostate through your rectum. They may be able to feel atypical growths or enlarged areas on your prostate that could indicate cancer.
A DRE does not require a lab, so your doctor can provide immediate feedback.
Prostate cancer gene 3 RNA test
Prostate cancer gene 3 (PCA3) is a genetic marker that doctors can analyze with a urine test. The doctor then sends your sample to a lab.
PCA3 is more abundant in prostate cancer cells, and many other prostate conditions do not affect it.
A newer urine test using 17 genetic markers also showed promising results in
Secondary screenings
Sometimes screenings can lead to false positives, so doctors will need a biopsy (tissue sample) to confirm a diagnosis. However, biopsies have their own risks and are an invasive procedure.
To avoid an unnecessary biopsy, a doctor may recommend a secondary screening first. This might include diagnostic imaging, such as an MRI or a transrectal ultrasound.
Imaging tests and biopsies will need to be performed in-office. The procedure can vary depending on the test needed.
Based on current research, the
The higher your risk for prostate cancer, the closer to age 40 you should begin the discussion and subsequent screening or testing.
How often you need to be screened depends on the outcome of the discussion with your doctor and, if tested for it, your PSA results:
- For those with a PSA of less than 2.5 ng/mL, a retest every 2 years may be required.
- For those with a PSA of at least 2.5 ng/mL, yearly screening may be required.
Those without symptoms and who have less than a 10-year life expectancy should not undergo prostate cancer screening, as they aren’t likely to benefit from it.
The purpose of screening for prostate cancer is to help detect the cancer at an early stage when it is more easily and effectively treatable.
Screening can help reduce your risk of death from prostate cancer by as much as 40%, according to a 2023 study.
The U.S. Preventive Services Task Force (USPSTF) found that prostate cancer may involve some risks.
Some stem from the possibility that screening can provide false-positive results. For example, elevated PSA could be due to other noncancerous conditions.
A false-positive result could lead to distress. Additionally, invasive follow-up tests and biopsies come with their own risks and could lead to complications.
False-negative results are also possible, meaning that the tests don’t indicate cancer even though you have it. This could lead to delayed treatment and a worsened outlook, as prostate cancer is typically asymptomatic until advanced stages.
Generally, if your PSA is greater than 2.5 nanograms per milliliter (ng/mL), you may be at a high risk of prostate cancer, while a result of
It’s important to remember that PSA test results are not definitive and can vary from person to person.
PCA3 results are also given as a score. Often, a score of 35 or greater indicates further testing, but not all experts agree on this cutoff — some say 25 is indicative of additional testing.
If you have a DRE result, the doctor can describe what they felt. Your prostate should be
If you just received a prostate cancer diagnosis, you might have many questions. It can be helpful to write them down in one place so you don’t forget them when you speak with your doctor.
You might want to ask about your:
- stage, grade (Gleason score), and spread
- treatment options
- costs and whether insurance might cover them
Relying on a close, trusted support network will also be important. Consider therapy or support groups to help you navigate your emotions.
If it’s medically safe, light exercise, time outdoors, and participating in activities you enjoy are important for your overall well-being.
All medical procedures involve some level of risk, but experts generally consider the procedures to screen for prostate cancer, such as PSA blood tests, PCA3 urine tests, and DREs, safe.
If you and your doctor decide to do prostate cancer screening, the age range experts recommend is from 55 to 69 years old.
For people who might be at a higher risk, screenings can begin at 45 years old, or as early as 40 years old.
Having a doctor examine your prostate every 2 years is usually sufficient for those with a PSA of less than 2.5 ng/mL.
If you’re at a high risk, your doctor may recommend annual screening.
Prostate cancer is often asymptomatic, so screening is the best way to detect it early.
Screening tests are not definitive. You may need multiple tests or follow-ups to determine your risk of prostate cancer. You can only receive a diagnosis after a biopsy.
Before undergoing prostate cancer screening, ask a healthcare professional about the potential risks and benefits so you can make an informed decision. The need for screening is determined on a case-by-case basis.