Early Detection
Early detection begins with screening. Screening refers to tests that look for signs of disease before you have any symptoms to help find cancer at an earlier stage when it might be more effectively and less invasively treated. Screening for any disease should lead to a better understanding of one’s overall health. The motivation should be to serve as a foundation for comprehensive and integrative primary prevention of disease, and multi- and interdisciplinary communications should disease occur.
Prostate cancer is the most diagnosed cancer in men (other than skin cancer) and the second leading cancer killer of men. Screening (PSA+DRE) is the cornerstone for finding prostate cancer early. Early detection allows for better treatment options. At present, cancer is usually diagnosed with a biopsy, a small tissue sample taken from the prostate. The biopsy, sometimes along with other tests, provides valuable information to help understand how potentially life-threatening your cancer may be.
The American College of Surgeons (ACoS) Commission on Cancer (CoC) accreditation requirements state “part of being a quality cancer program is not only addressing the program’s current patients, but also those in the community who may develop cancer or have difficulty receiving cancer treatment. Outreach to the community through screening and prevention events aids in reducing the risk of developing cancer and in diagnosing cancer at an earlier stage than it might be otherwise.” North Carolina is currently home to ~50 accredited programs. Section 8 of ACoS CoC standards: Optimal Resources for Cancer Care calls for professional and community outreach, including cancer prevention event(s) and cancer screening event(s).
Science, the foundation for developing guidelines and standards, is constantly evolving. Any man who chooses to participate in an event to learn more and take charge of his health should have access to the very best of what is known today. This is commonly referred to as translational research, “best practices,” “gold standards,” and/or “evidence informed” care.
EVERY MAN SHOULD HAVE A BASELINE RISK ASSESSMENT in his 40s. The assessment should include a men's health blood panel. AT A MINIMUM, the panel should include a prostate specific antigen (PSA), cholesterol, A1C blood tests. These results can empower the individual man to make changes if he is pre-diabetic or pre-hypertensive, and monitor his success by screening on a routine basis. The results of the PSA blood test can help him to better plan his future need for prostate screening based on his personal individual risk by referring to the diagram below. Further, these results might serve as a foundation for men to work with a primary care doctor that he selects to build a partnership designed to support his long-term health and well-being.
A full prostate health exam includes analysis of (PSA) bloodwork, and a physical examination of the prostate, also known as a digital rectal exam (DRE). While there are some very promising innovations being made in regard to imaging tests, these tests are still being clinically trialled and are often cost-prohibitive. The DRE remains an important tool for many medical professionals in underserved parts of the state. The DRE can find “low PSA producing” prostate cancers. These cancers can be very deadly and will not be found with a PSA test. Because some men fear the DRE, but not the PSA, well-informed screening programs are typically taking an “available and recommended, but not required” approach, noting that a full prostate screening does require both exams or appropriate imaging instead of a DRE.
Resources for building interdisciplinary community partnerships.
Prostate cancer is the most diagnosed cancer in men (other than skin cancer) and the second leading cancer killer of men. Screening (PSA+DRE) is the cornerstone for finding prostate cancer early. Early detection allows for better treatment options. At present, cancer is usually diagnosed with a biopsy, a small tissue sample taken from the prostate. The biopsy, sometimes along with other tests, provides valuable information to help understand how potentially life-threatening your cancer may be.
The American College of Surgeons (ACoS) Commission on Cancer (CoC) accreditation requirements state “part of being a quality cancer program is not only addressing the program’s current patients, but also those in the community who may develop cancer or have difficulty receiving cancer treatment. Outreach to the community through screening and prevention events aids in reducing the risk of developing cancer and in diagnosing cancer at an earlier stage than it might be otherwise.” North Carolina is currently home to ~50 accredited programs. Section 8 of ACoS CoC standards: Optimal Resources for Cancer Care calls for professional and community outreach, including cancer prevention event(s) and cancer screening event(s).
Science, the foundation for developing guidelines and standards, is constantly evolving. Any man who chooses to participate in an event to learn more and take charge of his health should have access to the very best of what is known today. This is commonly referred to as translational research, “best practices,” “gold standards,” and/or “evidence informed” care.
EVERY MAN SHOULD HAVE A BASELINE RISK ASSESSMENT in his 40s. The assessment should include a men's health blood panel. AT A MINIMUM, the panel should include a prostate specific antigen (PSA), cholesterol, A1C blood tests. These results can empower the individual man to make changes if he is pre-diabetic or pre-hypertensive, and monitor his success by screening on a routine basis. The results of the PSA blood test can help him to better plan his future need for prostate screening based on his personal individual risk by referring to the diagram below. Further, these results might serve as a foundation for men to work with a primary care doctor that he selects to build a partnership designed to support his long-term health and well-being.
A full prostate health exam includes analysis of (PSA) bloodwork, and a physical examination of the prostate, also known as a digital rectal exam (DRE). While there are some very promising innovations being made in regard to imaging tests, these tests are still being clinically trialled and are often cost-prohibitive. The DRE remains an important tool for many medical professionals in underserved parts of the state. The DRE can find “low PSA producing” prostate cancers. These cancers can be very deadly and will not be found with a PSA test. Because some men fear the DRE, but not the PSA, well-informed screening programs are typically taking an “available and recommended, but not required” approach, noting that a full prostate screening does require both exams or appropriate imaging instead of a DRE.
Resources for building interdisciplinary community partnerships.
- Michael ZD, Kotamarti S, Arcot R, Morris K, Shah A, Anderson J, Armstrong AJ, Gupta RT, Patierno S, Barrett NJ, George DJ, Preminger GM, Moul JW, Oeffinger KC, Shah K, Polascik TJ; Duke Cancer Institute Planning Committee for Prostate Cancer Screening. Initial Longitudinal Outcomes of Risk-Stratified Men in Their Forties Screened for Prostate Cancer Following Implementation of a Baseline Prostate-Specific Antigen. World J Mens Health. 2022 Aug 16. doi: 10.5534/wjmh.220068. Epub ahead of print. PMID: 36047079.
- Shah A, Polascik TJ, George DJ, Anderson J, Hyslop T, Ellis AM, Armstrong AJ, Ferrandino M, Preminger GM, Gupta RT, Lee WR, Barrett NJ, Ragsdale J, Mills C, Check DK, Aminsharifi A, Schulman A, Sze C, Tsivian E, Tay KJ, Patierno S, Oeffinger KC, Shah K. Implementation and Impact of a Risk-Stratified Prostate Cancer Screening Algorithm as a Clinical Decision Support Tool in a Primary Care Network. J Gen Intern Med. 2021 Jan;36(1):92-99. doi: 10.1007/s11606-020-06124-2. Epub 2020 Sep 1. PMID: 32875501; PMCID: PMC7858708.
- Aminsharifi A, Schulman A, Anderson J, Fish L, Oeffinger K, Shah K, Sze C, Tay KJ, Tsivian E, Polascik TJ. Primary care perspective and implementation of a multidisciplinary, institutional prostate cancer screening algorithm embedded in the electronic health record. Urol Oncol. 2018 Nov;36(11):502.e1-502.e6. doi: 10.1016/j.urolonc.2018.07.016. Epub 2018 Aug 28. PMID: 30170982.
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PHENpath - a Prostate Health Education Network (PHEN) Resource:
The Prostate Health Education Network (PHEN) has developed this outstanding educational resource. Please see PHEN's educational resources for more advanced diagnosis or advancing cancer below.
New biomarkers are being discovered! The PCEC is an excellent resource for keeping pace with these advances.
Prostate Conditions Education Council (PCEC) Resource:
Educational Resource for Imaging
National Alliance of State Prostate Cancer Coalitions Resource: Imaging in Prostate Cancer