Screening for prostate cancer includes both a prostate exam and a PSA blood test. The combination of these two tests provides improved diagnostic accuracy compared to either alone. Current guidelines recommend starting screening after a discussion of the risks and benefits with your primary care physician or urologist.

The age to start screening is 45 for most men, but those with a family history, genetic predisposition, or African descent should start at 40. Screening should continue every 1 to 2 years until the age of 75, or more in some patients. If an abnormality is noted, an MRI is often requested. Using MRI, patients can avoid prostate biopsy almost 30% of the time and improve diagnostic accuracy if biopsy is needed.

Treatment for prostate cancer varies between active surveillance (cancer surveillance), radiation therapy, surgery, and systemic treatment. In general, treatment options are based on risk stratification before treatment. For most men at very low or low risk of cancer, active surveillance is the preferred option.

If treatment is needed, using the latest techniques in radiation therapy or robotic surgery can maximize benefits and reduce risks. There are many new systemic therapies available to help men with disease that has spread to the lymph nodes and bones. One of the keys to these advances has been the progression of genetic testing and the possibility of more targeted therapy. Another development has been the FDA approval of the PSMA PET scan which allows very precise imaging of advanced prostate cancer. This test may be of benefit in men with advanced or recurrent prostate cancer.

We have made progress in the detection, staging and treatment of prostate cancer. The most important part of the process is a commitment to start screening. In September, we are happy to celebrate Prostate Cancer Awareness Month as an opportunity to raise awareness and start a discussion about this common and treatable disease.

The Mission Hope Cancer Center is pleased to offer free prostate cancer screenings on Saturday, September 25 for men who do not have insurance. To register, please call 805-219-HOPE (4673).

Dr Sam Kiely is a highly respected urologist oncologist and speaker on the topic of prostate cancer prevention and treatment, he can be reached at 805-349-7133.

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