September is Prostate Cancer Awareness Month, dedicated to raising awareness about a disease over 285,000 men will be diagnosed with during 2023, making it the second leading cancer of American men. Urologists recommend getting a baseline level done early in life to detect prostate cancer at its earliest and most treatable stage. Having this information can be extremely useful for future comparison. But while most men assume that only “old” men get diagnosed with this disease, surprisingly even men under age 50 are at risk.
It is alarming that one out of every eight men will receive a prostate cancer diagnosis. African-American men are at an even higher risk, with a one-in-three chance of being diagnosed. The American Cancer Society projects that approximately 35,000 men will lose their lives to prostate cancer during 2023, making it the second most common cause of cancer-related deaths in men. Therefore, it is essential to start detecting prostate cancer early, beginning at 40, as it can significantly increase the chances of saving men’s lives.
The prostate-specific antigen or PSA blood test is a quick and easy screening tool for prostate cancer that can be done in a doctor’s office. The test is sent off to a lab that will measure the amount of prostate-specific antigen in the blood. This antigen is a protein that’s released by the prostate gland and can increase in amount as men age due to various changes in the gland. In healthy men, the PSA level is usually below 4.0 ng/ml, but it’s still important to get screened regularly to ensure early detection and treatment if necessary.
However, there are differences of opinion among healthcare professionals and researchers on what age to begin baseline PSA testing. In 2012, the United States Preventive Service Task Force (USPSTF) advocated against urologists using the Prostate Specific Antigen (PSA) test to screen men of any age for prostate cancer.
Unfortunately, since that decision by the USPSTF in 2012 recommending against PSA screening for men of all ages, data has shown a decrease in rates of prostate biopsy and an increase in rates of American men being diagnosed with high-grade prostate cancer in the United States. Specifically, the yearly prostate biopsy rate dropped by 41%, PSA screening were down by 41% and the digital rectal exam was down by 60%. Consequently, the 2012 decision by the USPSTF resulted in increased prostate cancer rates, increased prostate cancer that had already metastasized, and increased rates of men dying from this disease.
Since then, the USPSTF has reversed course and now recommends that men aged 55 to 69 should converse with their doctor about the potential benefits and harms to decide whether to be screened for prostate cancer.
In 2016, Dr. David Samadi published a study in the journal of Urologic Oncology that compared 2,495 of his patients with prostate cancer who underwent SMART prostate cancer surgery. SMART is a minimally invasive, robot-assisted procedure Dr. Samadi uses in his practice.
The results showed younger men, compared to older men with similar demographic, clinical, and pathologic function, had surgical recovery statistically superior to the older men. Post-surgery, 12 months later, 94 percent of the young men and 83 percent of older men had normal sexual function. When looking at urinary continence 12 months later, results were even better, with 96 percent of young men and 94 percent of older achieving normal functioning.
“These findings demonstrate that young men under the age of 50 be screened with a PSA test”, stated Dr. Samadi. “PSA is an excellent diagnostic tool for finding prostate cancer in men in their 40s when it is often more aggressive. If prostate cancer is found, treatment and surgical outcomes are more favorable at a younger age. In addition, the current technology in robotic surgery makes it a literal lifesaver for many young men with a prostate cancer diagnosis.”
This same study also found that waiting to screen a man’s PSA until age 50 or older can result in missing an early diagnosis in up to 11% of patients who have the disease. Approximately 271 men from the study were found to have prostate cancer at a mean age of 46.
It is recommended to undergo a PSA baseline test at 40 as prostate cancer tends to be more aggressive in younger men under 50. By getting a baseline test early, men can be informed about their risk factors and potential genetic components. It is a better strategy than waiting until it is too late.
Starting PSA screening at age 40 can help detect prostate cancer early before it advances and becomes difficult to treat. Delaying screening until age 50 increases the risk of a more advanced stage of the disease, making treatment more complicated and affecting the outcome. Being proactive about men’s health is recommended by having a baseline level for comparison with future PSA tests. Educating men on prostate health, symptoms of prostate cancer, and how to stay cancer-free is also essential. Let’s prioritize early screening as a prudent step toward maintaining good health.
Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy. Dr. Samadi is a medical contributor to NewsMax TV and is also the author of The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911.