Part of deciding not to screen for prostate cancer is the acceptance that if you do develop prostate cancer it may be more advanced when found. The only method of treating it when it has spread beyond the prostate is hormone therapy aimed at slowing its growth. This involves eliminating or blocking the effects of testosterone. This involves either surgical removal of the testicles or drugs that block testosterone. This causes a loss of some male characteristics, notably sex drive and sexual function, and possible development of some female characteristics, such as tenderness and enlargement of the breasts, and even hot flashes. There is no evidence to show that aggressive screening and treatment prevents the development of advanced prostate cancer, but it may. If you choose not to screen, you must be willing to accept the possibility that if you get prostate cancer, it may be too advanced for traditional treatment.