By Rahim Mangalji, M.D. — Buffalo Medical Group, Primary Care

September is Prostate Cancer Awareness Month, a time to educate men and their families about one of the most common cancers in men. Prostate cancer develops in the prostate gland, a small gland that produces seminal fluid. While many prostate cancers grow slowly and never cause harm, some can be aggressive, which is why awareness and informed decisions about screening are important.

Screening can help detect prostate cancer before symptoms develop. The primary screening test is the prostate-specific antigen (PSA) blood test, which measures PSA levels. An elevated PSA level may indicate prostate cancer, but it can also indicate non-cancerous conditions such as an enlarged prostate (benign prostatic hyperplasia), a prostate infection, or other factors. While an elevated PSA does not necessarily mean cancer, further evaluation is needed to determine the cause.
 

An important part of screening is a conversation about its benefits and limitations. Screening can detect some cancers early, but it can also lead to false alarms, additional testing such as a prostate biopsy, and the detection and treatment of slow-growing cancers that may never have caused problems. Because treatment can cause urinary and sexual problems, national guidelines recommend that men make an informed, shared decision with their healthcare provider about whether PSA testing is right for them, based on their personal risk, values, and overall health. A digital rectal examination, sometimes used by providers to check the prostate for abnormalities, is no longer recommended as a stand-alone screening test, but may still be helpful in evaluating an elevated PSA result.
 

The age at which screening discussions should begin depends on an individual’s risk. The American Cancer Society recommends that men at average risk talk with their healthcare provider about screening starting at age 50. Men at higher risk should start these conversations at age 45. This includes men with a father or brother diagnosed with prostate cancer before age 65. Men at even higher risk, such as those with more than one close relative diagnosed with prostate cancer at an early age, should begin these discussions at age 40. 
 

In its early stages, prostate cancer often causes no symptoms. As the disease progresses, men may notice difficulty urinating, a weak urine stream, frequent urination (especially at night), blood in the urine or semen, erectile dysfunction, or pain in the hips, back, or pelvis. Because symptoms may not appear until later stages, a timely conversation about screening can be especially valuable.
 

Family health history is an important risk factor. Men with a father, brother, or multiple close relatives who have had prostate cancer face a higher risk of developing the disease. In some families, an inherited gene change (such as a BRCA mutation) can further increase this risk and may warrant genetic counseling. Sharing your family medical history with your provider can help determine when screening should begin and how often it should occur.
 

Treatment options depend on the stage and aggressiveness of the cancer. They may include active surveillance (close monitoring), surgery, radiation therapy, hormone therapy, chemotherapy, targeted therapy, or combinations of these approaches. Cancers detected at an earlier stage often have more treatment options and better outcomes.
 

Coverage for PSA testing can vary. Medicare typically covers an annual PSA screening for men aged 50 and older, but some commercial health insurance plans may apply cost-sharing or have different rules for screening versus diagnostic testing. Patients are encouraged to check with their insurer regarding coverage.
 

Primary care providers play a vital role in prostate cancer prevention and early detection. They help patients understand their personal risk, discuss the benefits and limitations of screening, interpret test results, and coordinate follow-up care as needed. By supporting informed decision-making and regular preventive care, primary care providers are often the first point of contact for a man’s prostate health.
 

Buffalo Medical Group Primary Care is accepting new patients at all locations. To schedule an appointment, call 716-656-4471.