The two most common tests used by physicians to detect
prostate cancer are the digital rectal examination (DRE)
and the prostate-specific antigen (PSA) test.
For the DRE, the doctor inserts a gloved and lubricated
finger into the rectum. This allows the doctor to feel
the back portion of the prostate (where most cancers
begin) for size and any irregularities. The PSA test
is a blood test that measures the prostate-specific antigen,
an enzyme produced only by the prostate, to see if the
PSA level is within normal limits. The doctor also may
use this test to check for any change in PSA level compared
to the previous PSA test.
For more information, please see
CDC publication Prostate Cancer Screening: A Decision
Guide. To download the pdf (228K) please
click here. To read the decsion guide online please
clcik here
CDC Screening Recommendations
Although there is good evidence that
PSA screening can detect early-stage prostate cancer,
evidence is mixed and inconclusive about whether early
detection improves health outcomes. Additionally, prostate
cancer screening is associated with important harms,
which include anxiety and follow-up procedures based
on test results that sometimes are false-positive, as
well as the complications that may result from treating
prostate cancers that, if left untreated, might not have
affected the man's health.
Because current evidence is insufficient
to determine whether the potential benefits of prostate
cancer screening outweigh important harms, there is
no scientific consensus that such screening is beneficial.
CDC and other federal agencies
follow the prostate cancer screening guidelines set
forth by the U.S.
Preventive Services Task Force, led by the Agency
for Healthcare Research and Quality.
CDC promotes informed decision
making, which occurs when a man understands the nature
and risks of prostate cancer; understands the risks
of, benefits of, and alternatives to screening; participates
in decision making at a level he desires; and makes
a decision consistent with his preferences and values,
or defers the decision to a later time.
U.S. Preventive Services
Task Force (USPSTF) (August 2008) Summary of Recommendations:
The USPSTF concludes that
the current evidence is insufficient to assess
the balance of benefits and harms of prostate cancer
screening in men younger than age 75 years.
The USPSTF recommends against
screening for prostate cancer in men age 75 years
or older. To go to the USPSTF website please
click here
Screening for
Prostate Cancer: U.S. Preventive Services Task Force
Recommendation Statement
Ann Intern Med. 2008;149:185-191. 8 pages (pdf 208K).
To download the pdf please
click here
What do we know about diet
and prostate cancer?
The Panel
concludes (Chapter 7.14, page 309):
Foods containing lycopene, as well as selenium and
foods containing it, probably protect against prostate
cancer. Diets high in calcium are a probable cause
of this cancer. It is unlikely that beta-carotene (whether
from foods or supplements) has a substantial effect
on the risk of this cancer. There is limited evidence
suggesting that pulses (legumes) including soya and
soya products, foods containing vitamin E, and alpha-tocopherol
supplements are protective, and that processed meat,
and milk and dairy products are a cause of this cancer.
Source: Second Expert Report:
Food, Nutrition, Physical Activity, and the Prevention
of Cancer: a Global Perspective. World Cancer
Research Fund / American Institute for Cancer Research
(WCRF/AICR), Washington DC: AICR, 2007. 537 Pages.
Note: PDF file of the complete report is 12 MB in size.
More about this report can be found on the “diet” link
[or some other name later] of this website. To download
the entire report (pdf 12MB) please
click here.
To download a summary of the report (16 pages, pdf 1.2MB) please
click here
To download the report’s summary
in other languages than English (WCRF website), please
click here
Resources for practioners
SCREENING
Clinical Practice Guidelines:
Prostate Cancer
The National Comprehensive Cancer Network (NCCN) 2008,
44 pages (pdf 300K). To download the pdf please click
here To learn how the NCCN Clinical
Practice Guidelines are developed please
click here
The National Comprehensive
Cancer Network’s NCCN Clinical Practice Guidelines
in Oncology™ are one of the most comprehensive and
most frequently updated clinical practice guidelines
available in any area of Medicine. Covering 97 percent
of all patients with cancer and updated on a continual
basis, the NCCN Guidelines are developed through an
explicit review of the evidence integrated with expert
medical judgment by multidisciplinary panels from NCCN
Member Institutions. Treatment recommendations are
specific and are implemented through performance measurement.
NCCN Guidelines Panels address cancer detection, prevention
and risk reduction, workup and diagnosis, treatment
and supportive care. Please visit the NCCN website
to ensure you have the latest treatment guidelines
available, since they are updated almost every year:
(free log in required to get to the guidelines) click
here
U.S. Preventive Services
Task Force (USPSTF) (August 2008) Summary of Recommendations:
The USPSTF concludes
that the current evidence is insufficient to assess
the balance of benefits and harms of prostate cancer
screening in men younger than age 75 years.
The USPSTF recommends
against screening for prostate cancer in men age
75 years or older. To go to the USPSTF website please
click here
Screening
for Prostate Cancer: U.S. Preventive Services Task
Force Recommendation Statement
Ann Intern Med. 2008;149:185-191. 8 pages (pdf 208K).
To download the pdf please
click here
Cancer
Screening in the United States, 2008: A Review of
Current American Cancer Society Guidelines and Cancer
Screening Issues
Robert A. Smith, Vilma Cokkinides, and Otis Webb Brawley.
CA Cancer J Clin 2008 58: 161-179. 20 pages (pdf 161K),
To download the pdf please
click here
Should mass screening for
prostate cancer be introduced at the national level?
Health Evidence Network (HEN), WHO Regional Office for
Europe, 2004. 12 pages (pdf 116K).
Policy considerations: Mass screening should not be introduced
at the national level, unless supportive evidence is
available from the ongoing screening or treatment trials.
To download the PDF file please
click here. To go to the WHO Europe wesite please
click here
American Cancer Society Guideline
for the Early Detection of Prostate Cancer: Update
1997
A. von Eschenbach, R. Ho, G. P. Murphy, M. Cunningham,
and N. Lin. CA Cancer J Clin 1997 47: 261-264. 4 pages
(pdf 50K) to download the pdf please
click here
US GOVERNMENT AND
GENERAL RESOURCES
The Centers for Disease
Control (CDC), the National
Cancer Institute (NCI) and the American
Cancer Society (ACS) provide
many on-line cancer resources. The great advantage
of these organizations is that the information gets
constantly updated, reflecting the latest scientific
findings. On-line texts have an interactive dictionary
where you can click on terms that sound unfamiliar
and get an explanation in plain English. For people
without on-line access these materials can also be
ordered in the mail or by phone.
The Centers for Disease Control (CDC)
is a leader in nationwide cancer prevention and control,
working with national organizations, state health agencies
and other key groups to develop, implement, and promote
effective cancer prevention and control practices.
The National Cancer Institute
(NCI)
is a component of the National Institutes
of Health (NIH), one of eight agencies that compose
the Public Health Service (PHS) in the Department of
Health and Human Services (DHHS).
The National Cancer Institute coordinates
the National Cancer Program, which conducts and supports
research, training, health information dissemination,
and other programs with respect to the cause, diagnosis,
prevention, and treatment of cancer, rehabilitation from
cancer, and the continuing care of cancer patients and
the families of cancer patients.
NCI publishes a wealth of information
about cancer on the Web. To make it easier for you we
have provided direct cervical cancer links from NCI below.
PDQ Colorectal Cancer for
health professionals (PDQ, as it is commonly known
stands for Physicians Data Query. The "health professional" link
is more scientific and focuses on treatment options)
To read the publication“What You
Need To Know About™ Prostate Cancer,”on-line click
here please
NCI's booklet "What
You Need To Know About Prostate Cancer To download the pdf file please
click here
American Cancer Society (ACS)
is
the nationwide community-based voluntary health organization
dedicated to eliminating cancer as a major health problem
by preventing cancer, saving lives, and diminishing suffering
from cancer, through research, education, advocacy, and
service. For prostate cancer information form ACS please
click here
Cancer
Screening in the United States, 2008: A Review of
Current American Cancer Society Guidelines and Cancer
Screening Issues
Robert A. Smith, Vilma Cokkinides, and Otis Webb Brawley.
CA Cancer J Clin 2008 58: 161-179. 20 pages (pdf 161K),
To download the pdf please
click here
Cancer is a disease in which cells
in the body grow out of control. Cancer is always named
for the part of the body where it starts, even if it
spreads to other body parts later.
