Prostate cancer is a killer, but early detection helps patients survive it, said Dr. Don McKnight, a board-certified urologist with Jackson Urological Associates.

However, new research has emerged about the accuracy and costs involved with the common Prostate-Specific Antigen (PSA) test, which has been used to screen patients for prostate cancer since the 1980s.

Dr. McKnight said it’s one of his profession’s hot controversies, and he discusses the issues in depth with his patients, explaining the risks and potential benefits. He then helps them determine the best option.

PSA is a protein produced by the prostate, and doctors screen for elevated levels in the blood to determine the presence of cancer. The test is a valid tool for early detection, Dr. McKnight said. “We’ve been able to show that it does detect early prostate cancer.”

His position is supported by the American Society of Clinical Oncology, the American Urological Association and the Prostate Cancer Foundation, which continue to recommend the test in the context of a man’s life expectancy.

However, researchers from the U.S. Preventive Services Task Force found that the test can produce false-positives and result in unnecessary treatment, exposing patients to the consequences of potential side effects. The government’s researchers also found that men with low levels of PSA could have prostate cancer, but the results of their test could prevent them from getting the treatment they need.

In a 2012 report, the task force reported that the potential harms of the screening outweigh the benefits, and it recommended against screening healthy men of all ages. The medical community remains divided on the issue.

Although he has shown the test to be effective, Dr. McKnight doesn’t recommend the test for everyone. Instead, he focuses on patients who fit the prostate cancer profile.

Young patients unlikely to have the disease or elderly patients with more serious health issues are not good candidates, he said. For example, it’s unnecessary to test patients with advanced heart or lung disorders who are likely to succumb to other illnesses before prostate cancer can be fatal.

But patients between 45 to 70 years old who are healthy and stand a good chance of living for another 15 years are good candidates, he said, explaining that a healthy, middle-aged man should get screened at least once, even if no symptoms are present. And higher risk patients, such as African-Americans and men with a family history of the disease, should get screened before they are 45, he said.

“It’s trying to find out who does need it, and it’s making sure you have that discussion with patients,” Dr. McKnight said.

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Don McKnight, M.D. Urology

Dr. Don McKnight, board certified in urology, joined the clinic in 1992. A Memphis native, Dr. McKnight received his medical degree from the University of Tennessee College of Medicine. His internship in general surgery and his residencies in general surgery and urology were at Medical College of Georgia in Augusta.