Paulo Bandeira Pinho, MD, FAAP

Text Box: Prostate cancer screening

The Importance of Prostate Screening

Prostate cancer is the most common cancer in men, and the second leading killer of men, behind lung cancer. Prostate cancer is generally very slow growing and most men die with prostate cancer (meaning that they die of some other cause) rather than from it. Still, it kills approximately 30,000 men each year. But detected early, it can be cured. In its early stages, prostate cancer usually doesn’t cause symptoms. However, as the disease progresses, the patient may develop symptoms that are the same as for prostatitis and/or BPH (see above).

Additional symptoms include:

Chronic pain in the hips, thighs, or lower back

Blood in the urine or semen


The lack of early symptoms and the overlap of symptoms with non-cancerous conditions makes prostate cancer difficult to diagnose. That's why it's essential that you get screened regularly.


The Prostate Gland

The prostate is a walnut-sized gland that forms part of the male reproductive system. The gland is made of two lobes, or regions, enclosed by an outer layer of tissue. The prostate is located in front of the rectum and just below the bladder, where urine is stored. The prostate also surrounds the urethra, the canal through which urine passes out of the body.

One of the main roles of the prostate, is to squeeze fluid into the urethra as sperm move through during sexual climax. This fluid, which helps make up semen, energizes the sperm and makes the vaginal canal less acidic.


PSA(Prostate Specific Antigen)

PSA is a protein produced by the prostate and released in very small amounts into the bloodstream. When there’s a problem with the prostate, such as when prostate cancer develops and grows, more and more PSA is released, until it reaches a level where it can be easily detected in the blood. During a PSA test, a small amount of blood is drawn from the arm, and the level of PSA is measured. PSA levels under 4 ng/mL are usually considered "normal," results over 10 ng/mL are usually considered "high," and results between 4 and 10 ng/mL are usually considered "intermediate”. However, PSA can also be elevated if other prostate problems are present, such as BPH and prostatitis. Also some men with prostate cancer have "low" levels of PSA. This is why both the PSA and DRE are used to detect the presence of disease.

DRE (Digital Rectal Exam)

Digital rectal examination. An examination in which a doctor inserts a lubricated, gloved finger into the rectum to feel for abnormalities. As unpleasant as it may be or seem, this is a man's first line of defense. The doctor checks for palpable (found by touch) abnormalities in the prostate, through the thin wall of the rectum. However, note that the entire gland cannot be checked, which is why a PSA test is also important.