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Medicare pays for many preventive services in order to aid you in staying healthy. Preventive services can find problems early and can help to keep you from getting certain diseases or illnesses. These services include exams, lab tests, and screenings. One of these services is the screening for prostate cancer.
What is Prostate Cancer?
The prostate gland is the male organ that produces fluid for semen. It is located behind the pubic bone and below the bladder. Prostate cancer is the most common type of cancer that affects American men, except for skin cancers. By about age 50, about one-third of men have some cancerous cells in the prostate gland. At around age 80, about three-quarters of men have some cancerous cells. As men age, the risk of prostate cancer increases. However, in most men with prostate cancer, the disease grows very slowly.
Advanced prostate cancer is cancer that has spread beyond the prostate gland to the lymph nodes, bones, or other organs of the body. Today, the prospect for recovery is getting better all the time, with a number of effective treatments available.
What is Prostate Cancer Screening?
A screening test is a process of looking for cancer before a person has any symptoms. It can help find cancer at an early stage. When abnormal tissue or cancer is found early, the disease may be easier to treat. By the time some symptoms appear, the cancer may have begun to spread.
You should remember that your doctor does not necessarily think you have cancer if he or she suggests a screening test. Screening tests are given when there are no cancer symptoms. Screening tests should be repeated on a regular basis. If a screening test does result in abnormal findings, you may need to have more tests done to find out if you have cancer.
Two different tests are used to detect prostate cancer in the absence of any symptoms:
- Digital rectal exam - a doctor feels the prostate through the rectum to find abnormalities in the texture, shape or size of the gland
- Prostate-Specific Antigen Test (PSA test) - a blood test is used to detect a substance made by the prostate gland to help liquefy semen, called prostate-specific antigen (PSA). It is normal for a small amount of PSA to enter the bloodstream. However, if higher than normal levels are found, it may be a sign of prostate infection, inflammation, enlargement or cancer.
Together, these two tests can detect many prostate cancers that have not yet caused any symptoms or problems. Due to the widespread use of PSA testing, approximately 90 percent of all prostate cancers are currently diagnosed at an early stage.
Does Medicare Cover Prostate Cancer Screening?
Medicare Part B covers prostate cancer screening, so that this cancer can be detected and treated early. Prostate cancer screening guidelines are the same for both procedures.
- Digital Rectal Examination is covered once every 12 months.
- Prostate-Specific Antigen Test (PSA test) is covered once every 12 months.
Do I Qualify for a Colorectal Cancer Screening? What Do I Pay?
All men over age 50 with Medicare are covered for this test. Generally, for the digital rectal exam, you pay 20% of the Medicare-approved amount. You will also have to pay the yearly Part B deductible. For the Prostate-Specific Antigen Test, you will not need to pay the coinsurance or the Part B deductible.
What is my risk for prostate cancer?
All men are at risk for prostate cancer, but the risk increases:
- If you have a father, brother, or son who has had prostate cancer, especially if your relatives were young when they got the disease
- If you are African-American. For unknown reasons, prostate cancer is more common in this ethnic group.
- As you get older. About two out of three prostate cancers are found in men over age 65.
- If you eat a lot of red meat or high-fat dairy products.