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A 58-year-old male asked:

When and how often do you recommend taking the psa test for prostate cancer screening? indicate your recommended frequency of the test and when to start taking it, if at all.

3 doctor answers7 doctors weighed in
Dr. Hal Jacobson
Radiation Oncology 42 years experience
The : The confusion is reflective of different recommendations based on different biases and goals. It is misleading to think of prostate cancer as a disease that never harms anyone. Prior to psa screening, 70% of prostate cancers were not detected until pain or other sever symptom of advanced disease occurred. Currently i rarely see advanced disease. Still, in the us each year, over 35, 000 men dye from prostate cancer. Many more are left impotent and weak with increased risk of heart disease by the hormone treatment of advancing cancer. I had my first psa at 50 and recommend that for the general public. However, you must be able to be patient in the interpretation of psa. This is where the controversy should be focused. In african americans or in cases with a family history of prostate cancer i recommend age 40 or earlier to start screening, these are 2 situation where earlier and more aggressive disease occurs more frequently. When you get your psa, keep your own chart of annual changes. The trend is more important than the absolute measure but non-specialists may not understand. The radiation oncology department at ucsf (your city) is one of the best i could recommend if an issue arises. Best wishes, hmj.
Dr. Lauren Stegman
Radiation Oncology 28 years experience
Controversial: Psa testing to screen for prostate cancer is controversial. Ultimately this is because some of the tumors found this way may be very slow growing and may never cause a man a problem in his lifetime. If these are treated, men might suffer side effects of a treatment they did not need. It is best to discuss the risks and benefits of testing with your physician.
Dr. James Krick
Dr. James Krick commented
Urology 37 years experience
Actually, there should be no controversy about testing for a disease. The only controversy is over treatment once discovered.
Jan 20, 2013
Dr. James Krick
Urology 37 years experience
PSA: Despite recent federal panel recommendations, i recommend annual psa testing for all men over 50. Prostate cancer has no symptoms in the early treatable stages.
Last updated Jan 31, 2018


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