“I feel fine.”
That may be true. It still does not tell you whether a prostate cancer screening conversation is due.
The prostate is a small gland below the bladder. Early prostate cancer often develops without noticeable symptoms. When symptoms occur, they can include difficulty urinating, a weak urine stream, blood in the urine or semen, or persistent pain in the back, hips, or pelvis. Other conditions can also cause these symptoms, so getting evaluated matters.
Knowing your risk gives you a starting point.
Age, Black ancestry, and family history can influence prostate cancer risk. The American Cancer Society recommends discussing screening:
- At 50: For men at average risk who are expected to live at least another 10 years.
- At 45: For Black men and men whose father or brother was diagnosed before age 65.
- At 40: For men with more than one first-degree relative diagnosed at an early age.
These are ages to begin an informed discussion, rather than automatic instructions to get tested. Professional guidelines differ, and your clinician should consider your individual health and preferences.
Understand what the test can, and cannot, tell you.
The main screening test is a blood test measuring prostate-specific antigen, or PSA. A raised PSA does not automatically mean cancer; noncancerous conditions can also raise it. Screening may help detect cancer earlier, but it can also lead to false alarms, additional procedures, and detection of slow-growing cancers that would never cause harm.
Bring these questions to your appointment:
- What increases my personal risk?
- What are the likely benefits and harms of screening for me?
- If my PSA is elevated, what happens next?
- When should we revisit this decision?
If you have symptoms, seek evaluation promptly, regardless of your age or screening schedule.
Your November challenge: Learn your family history and arrive at your next appointment with your questions written down.
