What you should know before you decide about prostate cancer testing.

Patient Decision Aid

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  1. All prostate cancers are not the same. Many prostate cancers grow slowly.  Many prostate cancers do not cause any harm or need treatment.  Some prostate cancers grow fast and can spread to other parts of the body.  This can cause problems and even death.  You can have prostate cancer and not have any symptoms.
  2. Who is most at risk for prostate cancer? Some men have a higher risk of having prostate cancer than others.  The following factors increase your risk of having prostate cancer:

Age:  Your age is your strongest risk factor.  Your chance of having prostate cancer goes up quickly after age 50.

Family history: If you have a father, son or brother who had prostate cancer you are twice as likely to get prostate cancer.

Race: If you are African American you are more likely to get prostate cancer.

  • Are you having symptoms now? If you have pain when you pass urine, blood in your urine, trouble passing urine, you should tell your doctor NOW. These can be symptoms of other prostate problems, but they can also be caused by prostate cancer.
  • What is prostate cancer testing? A PSA blood test and a rectal exam can tell your doctor about your prostate.  Your doctor might do a PSA blood test alone, or he might do both tests.
  • Can testing tell me for certain that I do or do not have prostate cancer? No – the tests are not perfect. The tests are the best we have today. Your test can suggest cancer is present when it is not. Your test can also miss prostate cancer when you actually have it.
  • So, what happens if my PSA or rectal exam suggests prostate cancer? If your test results are a cause for concern, you may need a biopsy to know for sure if you have prostate cancer.
  • What happens if the biopsy shows cancer? If the biopsy shows cancer cells, you and your doctor will decide how to treat cancer. You and your doctor may decide that treatment is not needed at this time.
  • What are the benefits of testing? Testing may find prostate cancer before it has spread. Finding prostate cancer early may give you a better chance of being treated and not dying from the disease. Getting tested may give you peace of mind.
  • And, what are the risks of testing? Getting tested may cause you to worry about your results. Testing may find cancer that may never have caused problems or caused death. Testing may lead to a biopsy and treatment for cancer that might never cause you any problem. Treatment can cause side effects. Your PSA may be low, even though cancer is there.
  • If you are treated for prostate cancer, treatment can cause side effects. Side effects can include: 
    • Problems controlling your urine
    • Problems controlling your bowels
    • Problems having sex

Below is a table to help you decide whether or not to be tested.

Some reasons to be tested (Check what is important to you)

  1. I will have peace of mind when I know the test results.
  2. My family and I will know if I have prostate cancer or not.
  3. I will have a better chance of getting treatment that could save my life if cancer is found.
  4. I have some risk factors that increase my chances of getting prostate cancer.
  5. Other reasons that are important to me. (Make a list)


Some reasons NOT to be tested (Check what is important to you)

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