Any man over age 50 should be screened routinely for prostate cancer. African American men could start the screening at age 45 because they are in a higher risk group and contract prostate cancer more commonly than Caucasians. Men with a family history of prostate cancer may want to start the screening at age 45 as well. When prostate cancer is diagnosed early, there are no symptoms. That is why it is important for men to go in for the screening tests.
Patients begin to develop symptoms in the later stages of prostate cancer.
They may experience blood in their urine and difficulty with urination. These are signs of advanced disease, and patients are no longer easily curable. The average patient comes in to see a urologist because he has had a routine PSA blood test in which the PSA level is elevated. This leads to a history and physical examination and ultimately a transrectal ultrasound and biopsy of the prostate. The need for any additional testing, such as bone scans or CAT scans, is determined by the PSA level and the Gleason score of the biopsied tissue, which is determined by the appearance of the tissue on a slide.