Prostate cancer screening: frequently asked questions
How is prostate cancer diagnosed?
The screening tests for prostate cancer are a blood test called a prostate specific antigen (PSA) test and digital rectal examination (DRE). To do DRE your doctor inserts a gloved finger into your rectum to feel your prostate gland.
These tests are not very accurate. DRE will miss many early prostate cancers and as many as two-thirds of men with a high PSA level will turn out not to have prostate cancer, and some men with a normal PSA will have prostate cancer. Also, although the PSA test is good at detecting prostate cancer, it is not very good at telling the difference between cancers that are slow-growing and cause no problems and cancers that are aggressive and could kill.
If your doctor suspects that you may have prostate cancer after doing a PSA test and DRE, you will need to have a biopsy to find out whether it is cancer. A biopsy involves having very small pieces of your prostate taken out by a needle so it can be checked under a microscope.
Why does my GP say I should be screened but The Cancer Council isn't so sure?
Prostate cancer screening is a very controversial issue, and health professionals do not agree on how to deal with it. GPs often recommend the test either as part of a routine check-up or as a way to check for prostate cancer after urinary problems are reported.
But shouldn't I have a PSA test if I'm having trouble passing urine?
Early prostate cancer does not cause difficulties in passing urine. Men who have difficulty passing urine are no more likely to have prostate cancer than men who don't. However, if you have urinary symptoms that are worrying you, it is important to talk to your doctor to find out what is causing the problem.
Why do we have a screening programme for breast cancer and not for prostate?
There is a well-established treatment for breast cancers that are found early, and we know that women with breast cancer will live longer and have a better quality of life if they find cancer early and have it treated. But for prostate cancer the benefits aren't so clear.
Does the availability of brachytherapy change any of this?
Brachytherapy is a treatment for prostate cancer that involves putting radioactive seeds into the cancer. There is no evidence available yet to say whether outcomes or side effects are any different with brachytherapy than with other treatments. It is a new treatment that could offer benefits in terms of outcomes and side effects but we don't know this for sure, according to The Cancer Council. Brachytherapy is not covered by Medicare yet and costs may vary among treatment centres.
For further information and advice, call the Cancer Helpline on 13 11 20.
Last Reviewed: 14 November 2001
