When is a Prostate Cancer Screening Too Late?

by | Nov 1, 2023 | Prostate Cancer

According to two recent studies, a ‘decline in prostate-specific antigen screening’ or PSA blood test screening for prostate cancer may be why more men are being diagnosed with ‘advanced prostate cancer.’  

The more advanced prostate cancer is when it is diagnosed, the more difficult it is to treat.

One study was published by the American Cancer Society and released earlier this year, and another was published in the Journal of The American Medical Association Oncology, (JAMA Oncology) in 2022 discuss this trend.

According to the American Cancer Society report, after a two-decade-long decline in death rates from prostate cancer, the rate rose 3% from 2014 to 2019. Many of the deaths were attributed to men being diagnosed with advanced disease. That is because the guidance from doctors about what age to get screened fluctuated during that time, and there’s continued debate about what age men should be screened.

Therein lies the problem and according to the study’s author there is a definite correlation between changes in the recommendations for PSA screenings and the later-stage diagnosis of prostate cancer among more men, which can be deadly.

Keep in mind – early diagnosis of prostate cancer significantly increases survival rates. Prostate cancer is the second leading cause of cancer deaths among American men. 

According to the JAMA study, which looked at 128 U.S. Veterans Health Administration facilities from 2005 to 2019, the facilities with higher PSA screening rates had lower metastatic prostate cancer rates among men.

Both studies show that screening may help diagnose prostate cancer earlier – when it is easier to treat.

Prostate Cancer Screening Age

So, when you should start screening? First, talk to your doctor about family history and health issues. That can influence when you start. Yet even doctors and researchers have differing views.

Here are guidelines from the Prostate Cancer Foundation:

  • If you have a family history of prostate cancer or if you are African American, screening should begin at age 40.
  • If you do not have a family history or are not African American, screening can start at age 45.
  • African American men, those of Scandinavian descent and anyone with a family history of prostate cancer is at an increased risk of developing prostate cancer. So, talk to your doctor about prostate health or see a urologist, who specializes in prostate health.

When to Stop Prostate Cancer Screenings

Researchers and doctors in favor of screenings say the earlier prostate cancer is detected, the better the chance of a cure. 

Those not in favor of screening say because prostate cancer generally grows slowly, and the side effects of treatment and some invasive screening tests can be difficult to manage it is better to do less screenings.

The United States Preventative Services Task Force or (USPSTF) has the following recommendations:

  • For men aged 55 to 69, having periodic screenings with the Prostate Specific Antigen (PSA) Test, a blood test measuring the levels of PSA, a protein made by the prostate, should be an individual decision. 
  • The USPSTF cautions that for some men, screening can lead to a false positive that can require additional testing, which can lead to complications.
  • The USPSTF does not recommend screening for those older than 70.

All men should consider these recommendations from the USPS Task Force very seriously because 50% or more of all prostate cancers thought to be slow growing turn out to be aggressive. 

Radiation Oncologist, Dr. Mark Pomper with the CyberKnife Center of Miami says, “Testing is not something men should put off. Get screened regularly and if your PSA level starts rising, keep a close eye on it. We just treated a 92-year-old patient who was assessed and was found to have prostate cancer. He was told by several doctors not to do anything about it, that at his age he is more likely to die of something else before prostate cancer, but that is not always true. 

Often, it is not slow-growing, and it can be aggressive. There are many things to evaluate if it should be treated right away. If you are healthy, active, and do not have any other underlying significant disease then treatment should be considered. Prostate cancer has a high cure rate if detected and treated early and can buy patients many years of good health.” 

Types of Screening for Prostate Cancer

 Traditional screenings include:

  • Prostate Specific Antigen (PSA) Test:  Generally, the higher the PSA level the more likely a prostate issue may be present.
  • The Digital Rectal Exam or DRE: A physical test where a doctor feels the prostate for abnormalities. 
  • When doctors find something concerning, the first step is a biopsy, which while necessary, can be a difficult experience, uncomfortable, and can also produce a false negative. That could mean a repeat biopsy.

CyberKnife for Prostate Cancer

If you have been diagnosed with prostate cancer, you have treatment options depending on the stage of your cancer, your age, and your health. 

Surgery, chemotherapy, other drug therapies, and radiation all treat prostate cancer. Sometimes doctors use a combination of treatments. 

The experts at the CyberKnife Center of Miami, a state-of-the-art, free-standing radiation cancer treatment center in South Florida, are here to help.

CyberKnife Miami uses non-invasive radiation therapy to treat prostate cancer.

While there are several types of radiation for prostate cancer, our experts believe stereotactic body radiation therapy or SBRT – the type of radiation used by CyberKnife Center of Miami — has some distinct advantages.

CyberKnife has few side effects. Its pinpoint radiation beams hit only the prostate, so we can give a much higher dose with a lot fewer treatments, leaving healthy surrounding tissue unharmed. There’s over 20 years of published studies support,” says Dr. Pomper.

  • The cure rate with CyberKnife for prostate cancer is up to 98%.
  • It is non-invasive. 
  • There is no anesthesia or cutting. 
  • There are no risks that come with other treatment such as surgery which can include infection and extended periods of downtime.
  • CyberKnife’s treatments can be done in five therapy sessions over 10 days instead of 42 over three months with other radiation treatments.
  • The CyberKnife radiation beams are exceedingly precise. 
  • That results in less risk of side effects including impotence and incontinence.

If you are diagnosed with prostate cancer, call CyberKnife Miami for a consultation at 305-279-2900 or go to our prostate cancer website now for more information.