His name is Abate. He is Ethiopian. In October 2006, he drove his wife to George Washington University Hospital for her annual physical. At the time, he was in his mid-50s. When he got out of the car he spotted a sign that read “Free Screening for Prostate Cancer.” So he thought to himself, “Why not.”

The screening revealed that his PSA blood test was 2.3 nanograms per milliliter (ng/ml). Doctors said this was within the normal range—which is 0 to 4 ng/ml—and that he had no reason to worry. So he didn’t—until six months later, when he had a full physical exam.

Although Abate’s PSA number was still within the normal range, it had jumped to 3.1. His urologist told him he had very minimal cancer, but if he wanted to have it removed he would schedule surgery for him right away.

But because he is a scientist and not one to plunge into action, Abate preferred to deliberate.

“I did a lot of reading and viewed various websites, such as GW and Johns Hopkins,” he says. “My initial reaction was to get the prostate out as soon as possible, but then I began considering other options. And then my reading told me, ‘Hey, wait—get a second opinion!’”

Abate wound up seeing Arthur L. Burnett II, MD, a professor of urology at the Johns Hopkins University School of Medicine in Baltimore.

Burnett’s findings were identical to those of Abate’s initial urologist. Burnett said there was no need to rush into surgery, but he suggested Abate undergo careful surveillance until the cancer became aggressive.

Currently, the cancer has remained unchanged, and Abate has spared himself the unpleasant side effects of prostate cancer treatment.

“I credit this man for learning as much as possible about his prostate cancer diagnosis and his treatment options in order to make that informed decision—and of course, for coming by to see me for a second medical opinion,” Burnett says. “The dilemma is the finding of prostate cancer that rates as a low amount or aggressiveness level, which could suggest a cancer that may never spread in his lifetime.”

For those unfamiliar with the prostate, the walnut-sized gland is a part of the male reproductive system. The prostate gland circles the neck of a man’s bladder and urethra (the tube that carries urine from the bladder). It produces the majority of the fluid found in semen, which men ejaculate during orgasm.

As men age, their risk of prostate problems increases. The most common prostate problems men experience are inflammation (prostatitis), enlarged prostate (BPH, or benign prostatic hyperplasia) and prostate cancer.

It is true that in Abate’s case, his initial PSA screening may have awakened him to the risks he faced from prostate cancer. But free widespread screening is still a hotly debated issue.

Here is the nub of the problem. Screening involves a simple blood test, the PSA (prostate specific antigen). The test measures the amount of proteins the prostate releases in the blood. If the number is high, more than say 4, it could signal a problem with the prostate.

But a problem with the prostate does not mean with any certainty that cancer is present. It may simply mean you have a benign prostate problem, such as an enlarged prostate, which is quite treatable. You could also simply have a urinary infection, easily cleared up with an antibiotic. Then again, the PSA number could indicate the presence of some cancer cells.

Hold on though. The presence of some cancer cells could be very minimal, too. If so, that is not a life-threatening situation.  Some men live with minimal cancer cells all their lives—they eventually die with prostate cancer present in their body, but it’s not what kills them.

So, what’s a doctor to do? The next test in this screening process is a biopsy. Here, the patient goes under anesthesia, (local or general) and the doctor takes tiny core samples from the prostate, sends them to a lab to see if traces of cancer are present. If cancer is found, that’s when a dialogue should take place between the patient and his doctor. How much cancer is present? How aggressive is the cancer? If there is only minimal cancer, should the patient do treatment at all? Maybe not! Perhaps he should be put under surveillance to see whether the cancer grows significantly—or perhaps he should simply do nothing at all.

It’s this stage that some people fear. Why? Because they don’t want to risk going through unnecessary treatments—including surgery or radiation.

In addition, many men don’t want to live with short-term urinary incontinence that may result from surgery. Nor do they want to risk losing the ability to have natural erections for a time. (Both of these conditions, by the way, are manageable, but they still cause anxiety in patients who are considering options.)

What’s surprising, though, is that of patients who undergo biopsies, 80 percent do not have prostate cancer. That’s all the more reason why there’s an urgency for finding a better simple blood test that is specific to prostate cancer. It could eliminate or certainly cut down on the number of biopsies.

It is important to emphasize that African Americans get prostate cancer at twice the rate of all other population groups. Latinos are not far behind. And men with a history of prostate cancer in their families are at high risk as well.

Now let’s address the question: Should men get random screenings?

If at all possible, men should sit down with their primary physicians and discuss screening. The doctor will invariably first do a test called a DRE (a digital rectal exam) to see if the back of the wall of the prostate seems smooth and healthy. If it’s not, he may suggest a PSA.

Men should realize that their doctors know their total health picture. A free screening center lacks that health history information.

If your PSA numbers are high, only your doctor can help decide whether you should be biopsied to determine if you really have prostate cancer and how aggressive it is.

In the final analysis, the patient is the one who decides what to do about a positive prostate cancer diagnosis. He can take treatment or decide against it.

In particular, men of African-American descent and those at high risk should see their doctors and establish a baseline PSA when they reach 40—other men should do so when they reach 50.

Having said all this, if a man in a high-risk group is not able to see a private physician or a hospital clinic, then it is advisable to participate in a free screening situation.

And, if his PSA numbers are considered high, he should seek the care of a competent physician.

Norman Morris, a former award-winning CBS News journalist, is the coauthor, along with Arthur L. Burnett II, MD, of Prostate Cancer Survivors Speak Their Mind: Advice on Options, Treatments and Aftereffects (John Wiley & Sons).