Prostate Screening: Why Early Detection Matters

Second to skin cancer, prostate cancer is the most common cancer affecting men, with approximately one in eight men diagnosed during their lifetime. While the statistics can be alarming, advances in screening, diagnostics and treatment have made prostate cancer highly manageable and curable.

In a recent interview, Armen Dikranian, MD, urologist and medical director of robotic surgery at Huntington Health, answered questions about the disease and stressed the importance of screening. "The earlier the cancer is diagnosed, the more options you have to manage it," he said.

Screening helps identify prostate cancer before symptoms develop, which is important because most men diagnosed with prostate cancer have no symptoms at all. "Prostate cancer typically doesn't cause symptoms unless it's very advanced," Dr. Dikranian explained. So, the goal is to find it before it causes problems.

Screening involves getting a simple blood test called a prostate-specific antigen (PSA), which is often part of routine, annual lab work. For men at average risk, screening typically begins between ages 50-55. For men who have a family history of prostate cancer (i.e., their father or brother have had it) or have a maternal history of breast cancer, their risk is higher, so starting screening at age 40 is recommended.

If a PSA test result comes back abnormal, oftentimes an MRI is ordered. If there's still a concern, a biopsy is taken to see if cancer cells are present in the tissue.

Patients who test positive for prostate cancer now have many options. Over the past decade, prostate cancer care has evolved significantly. New tools, such as MRI imaging with fusion biopsy and genomic analysis, are helping physicians make more personalized treatment recommendations.

Dr. Dikranian shared one of the most significant changes: "Maybe 20 years ago, we were treating everyone, but now we know that not every prostate cancer needs to be treated." Approximately one-third of his patients are candidates for active surveillance, a carefully monitored approach for slow-growing cancers.

For patients who do require treatment, minimally invasive options continue to expand. At Huntington Hospital, robotic-assisted prostate surgery has become the standard surgical approach, reducing recovery time and complications compared with traditional surgery. Huntington also offers high-intensity focused ultrasound (HIFU), a noninvasive treatment option for select patients whose cancer falls between active surveillance and more aggressive treatment.

Radiation therapy is another option for appropriately selected patients. At Huntington Cancer Center, an affiliate of Cedars-Sinai Cancer, tools such as Vision RT and HyperSight help your care team position you accurately, monitor movement, and clearly see the prostate and nearby organs during treatment. This can help make treatment more precise, comfortable, and efficient while reducing your time on the treatment table and protecting surrounding healthy tissue.

As for prevention, research from the American Cancer Society suggests that maintaining a healthy weight, eating fruits and vegetables every day, and limiting red meat may support overall prostate health.

But getting an annual PSA screening test is at the top of Dr. Dikranian's list. He warned that letting annual screenings lag can result in patients missing their window of opportunity for effective treatment.

For men approaching screening age or those with higher risk factors, a conversation with a primary care physician can be the first step toward protecting their long-term health. "It is very rare for someone to pass away from prostate cancer if they get their PSA checked annually," Dr. Dikranian said. "Early detection remains one of the most powerful tools in the fight against prostate cancer."