What increases the risk of prostate cancer?

The main risk factors include:

• Age: After age 50, your chance of having prostate cancer is increased.
• Race: For reasons that are not clear, men of African-American or African-Caribbean heritage have a higher risk of developing and dying of prostate cancer. They need to be screened earlier in life.
• Family history: If a close family member is diagnosed, your risk of the disease is greater than average.
• Inherited genetic mutations: There are many genetic mutations that are associated with prostate cancer, most notably BRCA1 and BRCA2. These genes are also closely associated with breast and ovarian cancer in females. If you have these cancers in your family, genetic screening may be of value to you.
• Diet: A diet that’s high in animal fats and low in vegetables may increase your risk of prostate cancer.

What’s the advantage of a PSA test?

Detecting certain types of prostate cancer early can be crucial in treating early and preventing bad outcomes. Elevated PSA results may reveal prostate cancer that’s likely to spread to other parts of your body (metastasize), or they may reveal quick-growing cancer that’s likely to cause other problems. Early treatment via an elevated PSA on a blood test can help catch the cancer early. Dr. Feifer Always limits the potential damage that a PSA test could have for you and your family, by only suggesting workup, treatment, and follow-up for cancers that are likely to cause problems in your life. In some cases where the cancer detected is a very low grade and very low-risk, less aggressive therapies such as active surveillance may be employed, that’s dramatically reducing the risk to you by limiting your exposure to therapy that may cause urinary or sexual side effects. The choice is ultimately yours if you would like to know about your risk, but rest assured, if you choose to have the PSA test, all efforts are made to educate you thoroughly about your choice and to limit potential negative aspects. one important aspect is the use of prostate MRI, something Dr. Feifer uses often to reduce unnecessary biopsies and focus on those patients who actually need to have their prostate tested

What else do I need to think about when going for a PSA?

Normal PSA elevations are related to cancer and not all PSA elevations need to be evaluated. It is very important to ensure that all work up and tests are done for elevations in PSA or discuss with your provider beforehand, and that you understand the risks and benefits of all steps.

What does Dr. Feifer recommend?

One of the most important things that Dr. Feifer does when he meets with patients, is to counsel regarding the need for further evaluation with a PSA elevation. A risk adapted and ultra-personalized approach is developed with each patient: There is repeat testing, use of genetic biomarker tests, the determination of baseline risk using prediction tools, use of PSA kinetics, a physical exam, MRI  and other tools. These are all taken into account before anything is done. You can be 100% sure that all avenues are explored, and that whatever decision is made, it is the right one for you.