Amid New Prostate Cancer Screening Guidelines, Doctor Reveals Top 4 symptoms He Looks For

Prostate cancer has been called an “epidemic of the modern age.”One in eight men will be diagnosed during their lifetime, and though most of them won’t die from it, prostate cancer remains the second-leading cause of cancer death in men, after lung cancer.Now, the American Cancer Society is urging regular screening, a key change from previous recommendations, which advised men only to talk with their doctor about whether testing makes sense.But the updated guidelines, published on Thursday, Nov. 12, instruct men who are between 50 and 69 years old and have an average risk of developing prostate cancer to be screened every two years.Patients at high risk, including Black men and those with a strong family history of prostate cancer, should undergo annual screenings beginning at age 45.NBC News medical contributor Dr. Akshay Syal called it a “pretty significant shift” — the first guideline change in more than 16 years. The message to men is: “You should get screened,” he noted.“The hope is to catch these things earlier,” Syal said on TODAY.Black men have a 67% higher incidence of the disease and almost double the mortality rate compared to white men, “an inequity that needs immediate reversal,” said Dr. William Dahut, chief scientific officer at the American Cancer Society, in a statement.The first step in screening is done with a blood test that measures the level of prostate-specific antigen (PSA), a protein made by the prostate. Abnormally high PSA levels may indicate a tumor, but secondary testing such as an MRI can determine who needs a biopsy and help avoid aggressive treatment of prostate cancers that aren’t life-threatening, the guidelines note.“PSA testing remains the cornerstone of detecting prostate cancer early, and we now have stronger evidence of its benefits,” said Dr. Robert Smith, director of the Center for Early Cancer Detection at the American Cancer Society, in a statement.When it comes to older men, the balance of benefits and harms remains “uncertain,” so those who are 70 to 74 years old should make a decision with their doctor on whether to be screened, the new guidelines note.Screening is not recommended for men who are 75 or older.‘Take It Seriously’The widespread impact of the disease is one reason Dr. Dan Childs became interested in treating it.“What stuck out to me was how common prostate cancer is. Prostate cancer is one of those diseases that’s so common that almost every family’s been touched by it,” Childs, a medical oncologist at the Mayo Clinic in Rochester, Minnesota, who specializes in treating patients with genitourinary cancers, tells TODAY.com.“I want men to take a diagnosis of prostate cancer seriously.”It’s estimated there will be more than 333,000 new cases in the U.S. in 2026, and 36,320 men will die from the disease. Former President Joe Biden is a high-profile patient. TODAY’s Al Roker was also treated for the disease.Older age is a risk factor. The chance of having prostate cancer “rises rapidly” after 50, the American Cancer Society notes. By the time men reach 70, almost half (46%), have some cancer cells in their prostate, a study found.‘Silent Disease’Doctors don’t know why the chestnut-sized gland — located just below the bladder and part of the male reproductive system — is so vulnerable to cancer, Childs says.Many men are surprised to learn prostate cancer is usually found through routine screening — not because it sends warning signs, he notes. It’s a “silent disease,” especially in the curable stages, researchers note.“Don’t wait for symptoms,” Childs warns.“Early prostate cancer can have no symptoms at all. So if you’re in your 40s or your 50s, especially if you have a family history of prostate cancer, it’s time to start talking with your doctor about whether PSA screening might be right for you.”As Childs treats men with prostate cancer, the possibility of developing the disease himself is on his mind as well.Knowing what he knows, here are the prostate cancer warning signs the doctor would pay attention to in his own body. He emphasizes most men don’t have symptoms.Persistent Changes in UrinationThis includes having a weak urinary stream, difficulty starting urination or waking up at night more often to go to the bathroom than before, Childs says.It could happen because an enlarged prostate can cause a mechanical obstruction as urine is leaving the body, and make it tougher to push the urine past it, he notes.“I’d pay particular attention to those types of symptoms,” Childs says, calling them the most common warning signs if symptoms do appear.Blood in the UrineThis may happen if the cancer is causing irritation in the lining along the path of the urine.“You have to be particularly vigilant when you’re seeing blood in a location that it shouldn’t be. That’s something never to ignore,” the doctor cautions.“So if you’re seeing blood in your urine, pay attention to that.”New Bone PainProstate cancer has a proclivity for spreading to bone, so if there’s new pain in the back, hips or pelvis that’s otherwise unexplained and persistent, it’s reason to talk to your doctor, Childs says. He calls this the second most common symptom.Former President Joe Biden is living with a “very debilitating” and “painful” aggressive form of prostate cancer that has metastasized to his bones, his son Hunter Biden recently said.Unexplained Weight LossMen with more advanced prostate cancer may start to get signals that something’s off, such as losing weight without trying or experiencing persistent fatigue they’ve never felt before, Childs notes.“Those are two symptoms that I take seriously and can occur regardless of somebody’s cancer type,” he says.Screening mainly involves a blood test that measures PSA, a protein that’s made by both normal prostate cells and prostate cancer cells, Childs says. Higher levels can be associated with prostate cancer.Based on the initial value of the PSA test and other risk factors, a primary care doctor can help determine when to repeat the testing, Childs notes. It’s key to know whether the disease runs in your family.The digital rectal exam doesn’t have as important of a role as the blood marker, he adds.“I don’t want the fear of a digital rectal exam to be a reason that men don’t seek prostate cancer screening because it can be accomplished without a digital rectal exam,” the doctor says.If a man has elevated PSA, he may get an MRI, a biopsy and, in some circumstances, a PET scan.Prostate Cancer TreatmentNot all cancers within the prostate are the same — the risk a tumor poses depends on the genetics of the cancer, and what drives it, Childs explains.After a man is diagnosed with prostate cancer, the next step is to figure out whether it’s simply present, or if it could metastasize and cause harm. Doctors work with patients to decide if the cancer needs treatment or not.A low-risk, small, slow-growing tumor can lead to active surveillance with repeat PSA tests, scans and potentially biopsies to make sure it’s “not evolving in a sinister way,” Childs says.More worrisome tumors may require surgery to remove the prostate and radiation. Cancer that has spread to bones usually requires systemic treatments “that go everywhere that blood goes,” such as hormone therapy, intravenous forms of radiation called radiopharmaceuticals and chemotherapy, he notes.“Prostate cancer is impactful, it is common, it’s scary. But our expectation — even if you are diagnosed with prostate cancer — is for you to live many, many years. We will cure a high proportion of men,” Childs says.“In a man diagnosed with advanced prostate cancer, I’ll tell them we’ll always be watching this cancer like a hawk. ... Thankfully, now men with even metastatic or advanced prostate cancer can live more than five to 10 years after diagnosis.”TODAY’s Symptom Check series features doctors, specialists and health experts who reveal the warning signs they’d look for in their own body when it comes to cancer and other diseases.