The pros and cons of screening for prostate cancer should be discussed with your doctor to help guide you in deciding if it is the right course of action.
Routine screening for prostate cancer in all men without symptoms is not recommended in New Zealand at present.
To help you decide if a prostate check is right for you, the Ministry of Health has developed the Kupe website. It will help you understand the risks, benefits and implications of prostate testing, so you can have an informed conversation with your doctor.
Video: The prostate-specific antigen test. To test or not to test? Michael Evans and Reframe Health Films Inc, 2014.
Do all men need to be screened for prostate cancer?
There is no clear yes or no answer to this question. The following story is how Dr Richard Ablin, the American founder of the prostate-specific antigen, illustrates the health dilemma his discovery created:
The story of Bill and John
"Bill and John. Both men are 65 and don't know they have prostate cancer.
Bill decides to have a prostate-specific antigen (PSA) test. The test leads to a biopsy which finds a cancerous tumour. He has surgery to remove his prostate gland and is left impotent and incontinent. He dies aged 75.
John has read up about PSA testing and decides not to get tested unless he has symptoms. At 70, he starts having problems, goes to his doctor and has a PSA test. John is diagnosed with prostate cancer and dies five years later.
Those who believe in PSA screening will claim Bill lived for 10 years after his diagnosis, whereas silly John lived for only five.
The truth of the matter is, both men died at the age of 75 and who do you think got it right?"
This question is still being debated, with no clear right or wrong answer yet being established.
Who can get tested?
Any man over the age of 50 who wants to know, should be offered a digital rectal examination and PSA test. If either is abnormal, your doctor will refer you to a specialist (urologist) to be considered for a prostate biopsy, in which small samples of the prostate gland are taken for examination.
The aim of these investigations is to find out if you might have early prostate cancer and, if so, whether it needs treatment. The treatment options can then be discussed with you.
If the biopsy shows no evidence of cancer you will be advised to attend future check-ups.
Family history is important
Any man around the age of 40 years who has a close relative with prostate cancer, especially if that relative had cancer diagnosed before the age of 60-65 years, should consider seeing his doctor for the above assessment. Discuss this with your doctor.