Early Prostate Cancer Detection: Why PSA Screening Matters

Dr. Paul Gellhaus, urologic oncologist and medical director of robotic surgery at City of Hope Cancer Center Phoenix, emphasizes that fear often keeps patients from prostate cancer screening.

Many avoid testing because they worry about discomfort or unnecessary treatment. But early detection through a prostate-specific antigen (PSA) test can catch cancer before symptoms appear, improving outcomes.

He compares it to going to the dentist — uncomfortable but worth it to prevent bigger problems. Even if a biopsy is needed, modern techniques minimize pain and embarrassment. For most men, a negative biopsy with a normal PSA provides long-term reassurance.

Transcript

What's most important for patients to take away from Prostate Cancer Awareness Month, and what would you like to see them really, really learning?

Yeah, I think there's a lot for patients. I think there's a lot of fear. They don't want to find something, because if they find something, then they have to treat it, and maybe they never needed this from the start. The process is uncomfortable, embarrassing, maybe painful. But the reality is, it's kind of like going to the dentist — you got to get it done; otherwise, you're going to get a cavity, and it's going to be worse. So there's a lot of value in doing preventative care.

I think what's confusing to the layperson, the everyday patient, is they think, "Oh, I don't have symptoms. How could I possibly have cancer?" That goes for a lot of cancers, but for prostate, it's actually confusing. There's a benign enlargement that causes lots of urinary symptoms. But the portion of the prostate that tends to develop cancer is very minimally symptomatic — or has no symptoms at all — and that can be misleading.

The point of screening, the whole point, is to detect it early, early enough before symptoms happen. So go get a PSA. If the PSA is normal, you don't have to have a rectal exam, which a lot of guys are freaked out about because of embarrassment and discomfort. If your PSA is elevated, there are ways to do prostate biopsies that aren't painful or embarrassing to experience.

If your biopsy is negative and your PSA is below a certain amount, your risk of dying of prostate cancer in 20 years becomes less than 1%, and that is incredibly valuable. So, I think it's worth it. It's worth it to get checked, and if it's positive, confirm whether it's cancer or not, and then you can relax and not worry about this. For the vast majority of people, if your biopsy is negative, you can feel reassured — not 100%, but for the vast majority.

Transcript has been edited for clarity and conciseness.

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