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Are You Too Old to Be Screened for Prostate Cancer?

Dr. Seth Lerner, Urologic Oncologist

August 30, 2019

Are You Too Old to Be Screened for Prostate Cancer?

Essential prevention and treatment advice for Prostate Cancer Awareness Month.

The short answer is… no. However, you may not be “too young,” either. Prostate cancer is a malignant cancer that can spread to the lymph nodes, bones and other parts of the body. When caught early, prostate cancer is highly treatable and curable. Minimally invasive treatments using robotics surgery are leading to fewer side effects than ever before, and newer radiation treatments have also significantly reduced side effects.

While some guidelines base the recommendation for whether men should have a prostate-specific antigen (PSA) blood test for prostate cancer on age alone, that should not be the only factor when considering the screening. Men with a first-degree relative (father, brother) diagnosed with prostate cancer, men with a strong family history of breast cancer, men of African-American descent and men who were first responders at Ground Zero should certainly be screened.

Today, fewer men over the age of 70 are getting PSA blood tests, and yet, more men over 75 are dying from prostate cancer than younger men with the disease. Without strong recommendations in place, many men decline the PSA because they are afraid of possible side effects such as erectile dysfunction and loss of bladder control, along with no guarantee of a longer life expectancy.

To make the most informed decision about getting the PSA, men need to consider their overall health and life expectancy. If you’re a 60-year-old man who is already suffering from other, more severe health issues, the PSA may not be as important. But a 72-year-old man in excellent health whose parents lived well into their 90s should consider getting screened.

In other words, if person has at least a 10-year life expectancy, and likely many more years, they should consider PSA screening.

There is also the stage of cancer to consider. Degrees of tumor aggressiveness vary, and not all men diagnosed will require intervention. Up to half of men with a low risk of prostate cancer here at White Plains Hospital are being managed by active surveillance and not aggressive treatment.

Our Prostate Program implements genomic testing – a standard part of breast cancer screening for over a decade but relatively new for prostate cancer – in combination with the grade of the cancer to determine the most accurate risk analysis. The goals of active surveillance are to defer treatment for as long as possible, or avoid it altogether.

While the controversies around PSA testing and its varying viewpoints and opinions remain, the bottom-line advice is simple: If you are over 45 and have a life expectancy of 10 years or more, you should ask your primary care doctor for a PSA, including a digital rectal exam.

Dr. Seth Lerner

Dr. Seth Lerner is Director of The Prostate Program/Urologic Oncology at Advanced Urology Centers of New York/White Plains Hospital, with offices at our 170 Maple Avenue location. White Plains Hospital has one of the busiest robotic surgery centers in Westchester County for prostate cancer treatment. To make an appointment, call 914-949-7556.


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