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For the week of: 11/23/98 by Dr. Mohammed N. Mona, M.D.

Question: "I'm a 26 year old male with a family history of prostate cancer. At what I age should I start being checked for this?"

Answer: It is good that you are aware of the importance of having a family history of prostate cancer.

At age 40 and after, you should have a serum PSA (prostate specific antigen) and digital rectal exam yearly.

Editors Note: Here are a few facts about prostate cancer.

The American Cancer Society (ACS) estimates that about 245,000 men in the United States will be diagnosed with prostate cancer this year; about 40,000 will die of the disease. Because prostate cancer is a disease of older men, these numbers may reflect, in part, the increased life span men now enjoy.

The cause of prostate cancer is still unknown. Research suggests a combination of hormonal and genetic factors and perhaps dietary and environmental causes. What is clear is that early detection and improved treatments present men with important choices that may affect the length and quality of their lives. 

The risk of prostate cancer increases with age. Black men and men with a family history of prostate cancer (especially father or brother) are also at greater risk. 

In its earliest stages, prostate cancer may not cause symptoms. Therefore, the most important thing is that your physician include a digital rectal examination as part of your physical. According to the American Cancer Society (ACS), men age 40 and over should have annual digital rectal examinations. 

The ACS and the American Urological Association recommend that if you're over age 50, you also should have a prostate specific antigen (PSA) blood test every year.

If you're a black man or a man with a strong family history of prostate cancer, the PSA should be done annually starting at age 40.  

The PSA is a blood test that measures the amount of a protein (prostate specific antigen), which is secreted into the blood by the prostate gland. This antigen is produced by both normal and cancerous cells. Although some cancers produce PSA levels that measure in the normal range (0 to 4), most prostate cancers produce increased amounts of this antigen. A normal result does not exclude the presence of prostate cancer. But when the PSA is above normal, it suggests the possibility of prostate cancer. There are, however, other benign (non-cancerous) prostate conditions that can cause an elevation in the PSA level. 

The PSA test alone is not conclusive, and its use continues to be debated and refined. 

Prostate cancer warning signs: Consult your physician if you experience any of the following: 

  • Pain and/or difficulty in urinating

  • Blood in your urine

  • General pain in the pelvic area lasting several weeks or more

  • Loss of appetite and weight

  • Marked frequency and urgency of urination; or
    frequent night-time urination

Dr. Charles H. Booras, M.D.

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