Finding prostate cancer early

There is currently no national screening program for prostate cancer. However, there are prostate specific antigen (PSA) tests. The test has limitations and it’s important to talk to your doctor about the benefits and risks to make informed decisions about testing.

The PSA test is a blood test that measures levels of prostate-specific antigen (PSA), a protein made by both normal prostate cells and cancerous prostate cells. 

Higher PSA levels can sometimes be a sign of prostate cancer including prostate cancers that may benefit from treatment. PSA levels can rise for many reasons, such as benign prostate enlargement (hyperplasia), inflammation or infection of the prostate (prostatitis) and ejaculation within the previous 48 hours.

PSA testing may help find high-risk, fast-growing prostate cancers earlier. It can also detect very slow-growing cancers that may never cause harm, which can lead to further tests or treatment that may not be needed. Some treatments for prostate cancer can cause long-term side effects including changes to sexual function, bladder control and bowel habits. 

Talking with your doctor about your personal risks and what a PSA test can and cannot show helps you make an informed decision about whether testing is right for you.

If your doctor requests a PSA test and you meet Medicare criteria, the test is usually covered and should be available for free. Your doctor will also be able to explain what the results of your test mean and can also refer you to other tests you may need. 

At-home PSA test kits are not recommended. The tests could be unreliable and do not come with qualified medical advice to help interpret the results.

For more information, see Cancer Council Australia’s ‘Clinical Guidelines for PSA testing and early management for test-detected prostate cancer’. 

If you choose to have regular PSA tests, the current guidelines suggest that: 

• men with no family history of prostate cancer can have PSA testing every two years from age 50 to 69 years 
• men with a family history of prostate cancer can have PSA testing every two years starting from age 40-45 (depending on how strong the family history is) to age 69. 

Complementary or herbal supplements claiming to reduce PSA readings, or to prevent PSA from rising, are not recommended by Cancer Council. 

Early prostate cancer rarely causes symptoms. Even people diagnosed with advanced prostate cancer may have no symptoms. 

You should see your doctor if the following symptoms are ongoing: 

• difficulty passing urine
• frequent or sudden need to urinate
• blood in the urine or semen
• a slow flow of urine
• needing to get up at night to pass urine
• feeling like your bladder is not empty after passing urine 
• unexplained weight loss 
• pain in bones (e.g. the neck, back, hips or pelvis). 

While prostate cancer is less common if you are aged 50 and under, people aged 40 and over may have a higher risk than average of developing prostate cancer later in life if their PSA test results are higher than the typical range for their age.

Other factors that increase the risk of developing prostate cancer include: 

• getting older - especially being aged 50 and over (more than 90 per cent of people diagnosed with prostate cancer are aged 55 and over) 
• family history of prostate, breast or ovarian cancer
• being of African or African-American descent. 

Having a strong family history of cancer can increase the risk of developing prostate cancer. 

You may have inherited a gene that increases your risk of prostate cancer if you have: 

• several close relatives on the same side of the family with prostate, breast and/or ovarian cancer, especially if due to a fault in the BRCA1 or BRCA2 genes 
• a brother or father diagnosed with prostate cancer before the age of 60. In this case, your risk is twice that of others. 

If you are worried about your family history, talk to your doctor or call Cancer Council SA on 13 11 20.