Merck Manuals Shares Details to Help Patients Navigate the Controversies of Prostate Cancer Screenings

Latest editorial outlines five things men should know about when - and if - to get screened

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Sep 24, 2021, 09:00 ET

KENILWORTH, N.J., Sept. 24, 2021 /PRNewswire/ -- Few preventative tests are as debated and controversial as prostate cancer screenings. Recommendations for the test vary among professional groups such as the The National Comprehensive Cancer Network, the American Urological Association, and the American Cancer Society, leaving men and their families to navigate conflicting and confusing information about when – and if – they should be screened.

In a recent editorial, Leonard Gomella, MD, The Bernard W. Godwin Professor of Prostate Cancer and Chairman, Department of Urology, Sidney Kimmel Cancer Center at Thomas Jefferson University, shared some key facts men should take into account when considering a prostate cancer screening and discussing the test with their doctor.

1. Prostate Screenings Have Changed in the Last Several Decades

The first thing to understand about prostate screenings is that they are different than they were a generation ago. In the past, screenings involved a rectal exam to physically examine the prostate and determine if a biopsy was warranted. Today, and for the last several decades, physicians have increasingly relied on a blood test to measure a substance made by your prostate called PSA.

2. There are Pros and Cons to Prostate Cancer Screenings

The greatest benefit to screening is detecting aggressive forms of prostate cancer early. At the same time, the screening itself and potential biopsy presents some risks, including bleeding and infection. What's more, prostate cancers tend to grow relatively slowly, and there is a concern that the side effects of treatment, which can include erectile dysfunction or urinary incontinence may be more damaging than leaving the cancer untreated.

3. Prostate Cancer Doesn't Always Require Surgery or Radiation Therapy

Even when prostate cancer is detected, physicians today often recommend active surveillance (formerly called watchful waiting), meaning doctors give no treatment unless the cancer is progressing or changing. This can be a stressful situation for men to find themselves in, but it's important to understand the true risks and talk to a doctor about the best way to proceed with treatment.

4. Screening Recommendations Vary Significantly

Specific recommendations vary by group, but screening is considered in all men with a life expectancy of at least 10 to 15 years who are also older than 50 and in some who are younger who have risk factors, such as being African American or having a family history of prostate cancer or breast cancer. Benefits of screening may decrease with age.

5. Men Should Make the Decision for Themselves – with Input from a Doctor

Given the complications and controversies surrounding prostate cancer screening, virtually all organizations agree that no one should be screened without first having an in-depth conversation with their doctor to discuss the uncertainties, risks, and benefits.

Read more about prostate cancer screening considerations in Dr. Gomella's editorial on MerckManuals.com

About The Merck Manuals and MSD Manuals

First published in 1899 as a small reference book for physicians and pharmacists, The Merck Manual grew in size and scope to become one of the world's most widely used comprehensive medical resources for professionals and consumers. As The Manual evolved, it continually expanded the reach and depth of its offerings to reflect the mission of providing the best medical information to a wide cross-section of users, including medical professionals and students, veterinarians and veterinary students, and consumers. In 2015, The Manuals kicked off Global Medical Knowledge 2020, a global initiative with the goal to make the best current medical information accessible by up to three billion professionals and patients around the world by 2020. The Manuals achieved that goal, and today its medical information is available in more than 241 counties and in dozen languages. It's continuing its ambitious mission through outreach, education and creating new reliable medical resources. For access to thousands of medical topics with images, videos and a constantly expanding set of resources, visit MerckManuals.com or MSDManuals.com and connect with us on social media:

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SOURCE The Merck Manuals