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    Prostate Screening

    Talk to doctor. Decide together.

    Two main tests

    • PSA blood test — measures prostate-specific antigen.
    • DRE (digital rectal exam) — physical exam.
    • Combined for best detection.
    • Both quick.
    • Discuss with doctor — controversies exist.

    When to screen

    • Age 50 — start discussion average risk.
    • Age 45 — Black men, family history.
    • Age 40 — strong family history.
    • Age 70+ — discuss continuing.
    • Stop if life expectancy under 10 years.
    • USPSTF: shared decision-making 55-69.

    PSA controversy

    • High PSA doesn't mean cancer (also BPH, infection).
    • False positives common.
    • Leads to unnecessary biopsies.
    • But catches early cancers.
    • Discuss YOUR risks with doctor.
    • Family history changes calculus.

    Watch + wait

    • Many slow-growing prostate cancers.
    • Active surveillance — monitor without immediate treatment.
    • Many die WITH not FROM prostate cancer.
    • Treatment side effects (incontinence, ED) significant.
    • Aggressive cancers need treatment.
    • Decision is personal.

    Symptoms to mention

    • Trouble urinating.
    • Weak / interrupted stream.
    • Frequent urination at night.
    • Blood in urine or semen.
    • Pelvic / lower back pain.
    • Erectile dysfunction.
    • Many = BPH not cancer, but check.

    Make informed decision

    Read American Cancer Society guidelines (cancer.org). Discuss with primary doctor. Consider urologist consultation. Strong family history = screen. Most senior men benefit from at least baseline PSA. Discuss every visit. Free with Medicare.