Screening for Prostate Cancer Is Now Less Invasive and Still Life-Saving.

Prostate cancer is the second most common cancer in the U.S., and if it’s detected early there are many effective treatments. Yet many men avoid getting screened, both because these tests have a reputation for being invasive and because many men misunderstand their risk.

Because of its location, the simplest route to examine the prostate is through the rectum. This is a digital rectal exam (DRE), in which a doctor inserts a gloved, lubricated finger into the rectum to feel for potential signs of prostate cancer, such as lumps or enlargement. 

Men may be leery of the exam, but rest assured that TV depictions are overblown. The doctor will spend 10-15 second feeling the prostate, and the exam is not painful. It’s over before you know it, and can potentially be lifesaving if we spot signs of cancer.

Finding cancer early gives us a chance to treat it before it can spread to the nearby organs or bones. Prostate cancer can causeblood in the urine, painful ejaculation, problems with urination, and significant back and pelvic pain. Left untreated, it can be fatal. Athlete and actor OJ Simpson died from prostate cancer in April 2024.

When caught and cared for, prostate cancer is among the most treatable cancers. About 96% of men who get treatment for prostate cancer are still alive after five years. Getting screened before symptoms start is the best way to stop cancer before it can impact your sex life, relationships, and overall health.

MedStar Georgetown Cancer Institute at MedStar Washington Hospital Center is home to the most advanced prostate cancer screening and treatment technology. Our award-winning team combines decades of expertise in traditional care with the latest techniques to spot cancer early and treat it with limited impacts on your daily life.

Prostate cancer cases are expected to double to 2.9 million globally by 2040 due to demographic changes and more men living longer. If you’re eligible for screening, now is a great time to talk with your doctor about getting tested for prostate cancer.

Who should get screened for prostate cancer?

About 1 of every 8 men will be diagnosed with prostate cancer, and every individual’s risk is different. Men at average risk—generally can begin screening at age 55. Men with risk factors, either due to genetics and family history or lifestyle, should talk with their doctor about starting screening at age 40-45.

Risk factors for prostate cancer include:
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• Age: Prostate cancer is uncommon in men younger than 40, but after age 50 your risk rises. About 60% of prostate cancers are found in men over age 65. 
• Genetics and family history: Certain gene mutations inherited from your parents can raise your risk. If you have a history of prostate, breast, or ovarian cancer in your family, you may carry genes that make it more likely you’ll develop prostate cancer yourself. If your brother or father had prostate cancer before age 65, you may need earlier screening.
• Ethnicity: Prostate cancer occurs more often in Black men and Caribbean men of African ancestry. Men of Asian American, Hispanic, and Latino backgrounds tend to get prostate cancer less often than white men. Doctors don’t yet know why these racial differences exist. 
• Lifestyle: Eating fresh foods like fruits and vegetables and lean meats like fish instead of processed foods, sometimes called a Mediterranean diet, can reduce your risk. Studies have shown that getting at least 30 minutes per day of exercise at least three times a week can lower the risk of prostate cancer.

Prostate cancer usually does not cause symptoms until it is advanced, and some symptoms overlap enlarged prostate (BPH), a benign but uncomfortable condition. If you notice these symptoms, see a doctor right away to get an accurate diagnosis: 

• Blood in the urine or semen 
• Difficulty starting urination 
• Difficulty emptying the bladder 
• Pain or burning during urination 
• Pain in the back, hips, or pelvis 
• Pain upon ejaculating 
• Urinating often, especially at night 
• Weak flow of urine

Related reading: Prostate Cancer: What Every Guy Needs to Know

Non-invasive prostate cancer screening.

Along with the traditional DRE, MedStar Washington Hospital Center specialists use non-invasive biomarker tests and imaging to diagnose or rule out prostate cancer.

• Advanced blood tests: The prostate-specific antigen (PSA) blood test measures the amount of PSA, a protein made by the prostate, in your blood. High levels sometimes indicate the presence of cancer, or a benign enlargement of the prostate.
• 4Kscore: A math formula that combines the total PSA with other measures like free PSA and -2 proPSA to help predict the presence of cancer.
• Multiparametric MRI of the prostate: An advanced MRI scan of the prostate using magnetism and radio waves that results in a detailed picture of the gland.

These noninvasive tests help us learn more about your prostate health to decide whether we need to conduct a biopsy, in which we take a small sample of the prostate tissue to test it for cancer cells. We are performing far fewer biopsies than ever before. 

If we suspect prostate cancer, your doctor will recommend a biopsy to confirm the diagnosis. And if we find cancer, we will customize a treatment plan that works for your condition and lifestyle.

Related reading: Why I Stand Behind Digital Rectal Exams for Prostate Cancer Screening
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Minimally invasive prostate cancer treatments.

MedStar Washington Hospital Center has the latest state-of-the-art technologies and techniques to treat prostate cancer. The best outcomes happen when we can intervene early, when the cancer is contained to a relatively small portion of the prostate.

When we can treat cancer early, we can use simpler methods that have less impact on the sensitive tissues near the prostate that are responsible for bladder, bowel, and sexual function. World-class surgeons and radiation oncologists working together to refine our techniques have developed surgeries that have help many patients recover more fully from prostate cancer treatment.

• Athermal nerve sparing surgery: This robotic-assisted prostatectomy developed at MedStar Health improves outcomes like potency  and quality of life two years after surgery without compromising cancer care.
• Pelvic fascia-sparing surgery: This robotic prostatectomy studied at MedStar Health approaches the prostate in a new way that means men have 80% less urinary incontinence in the year after surgery.

Some of the leading treatments we offer include:

• Active surveillance: Prostate cancer usually grows slowly, and small cancers may never expand enough to warrant treatment. We can watch small, contained cancers and be ready to provide treatment if needed.
• Robotic-assisted surgery: Advanced procedures with the da Vinci surgical robot allows the surgeon to precisely remove the prostate with minimal damage to surrounding nerve tissue and muscles. Robotic-assisted surgery allows patients to recover much faster than earlier surgical methods. We’ve performed more than 5.000 robotic prostate surgeries since 2003.
• HIFU: Sonablate High Intensity Focused Ultrasound (HIFU) is a targeted therapy that destroys early stage prostate cancer without cutting, radiation, or hormones while leaving healthy portions of the prostate intact.
• Stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT): A fast, effective surgical option for cancer treatment, SRS uses a precise real-time tracking system to track tumors and minimize the radiation dose to surrounding tissue. Often called CyberKnife, SBRT allows us to precisely target diseased tissue in just five treatments compared with the traditional 40 sessions. We are among the most experienced centers with this technology on the east coast.

For patients with more advanced cancers, personalized chemotherapy, immunotherapy, and targeted and hormone therapy may be part of a treatment plan. These are only a few examples of the array of advanced prostate cancer treatments available at MedStar Washington Hospital Center. 

Prostate cancer is a sensitive topic in a sensitive part of the anatomy. If you are over 50, or over 40 and at higher risk, be sure to talk with your doctor about prostate cancer screening. These days, there’s very little to fear and a whole lot to gain from getting checked out.
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