The benefits of screening and treating prostate cancer are not clearly established. And, if they exist at all, they are many years away. On the other hand, the side effects of treatment are well known and immediate. This makes it very difficult to make decisions about whether to undergo screening tests or, if cancer is found, to begin treatment. What is right for one man may not be for the next. It becomes a matter of personal values and preferences concerning the future.

Some questions to think about before you decide about a screening plan include the following:

• What would you do if your screening test came back positive? Many tests are false positive. How would you feel if you were told that you had cancer, but you really didn’t? Would it cause you anxiety? Would you be angry? Would you be relieved when you got the biopsy results?
• What would you do if you did have prostate cancer? The treatment decision makes the screening decision seem almost simple. How do you feel about cancer? Would it cause you stress simply knowing that you have it? Do you want to do everything that you can to find it as early as possible?
• Would it make a difference to know if you did have prostate cancer? Would you want to do everything possible to get rid of it? Are you prepared to treat it aggressively as most doctors recommend if they think it is curable? Or would you prefer to live with it knowing that it is probably growing so slowly that it will not cause any problems?
• Is living as long as possible the most important thing, even if it means your quality of life may not be as good? Or is having a good quality of life more important than living a little longer?
• How would you feel if you had problems getting an erection?
• How would you feel about having some urinary difficulties, perhaps needing to wear a pad to protect against leakage?
• How would you feel about taking hormones that may reduce your sex drive or cause your breasts to enlarge?