Thursday, March 22, 2018

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Prostate's Big Eight

Written by  Rick Piester

September is Prostate Cancer Awareness Month, a time set aside each year to focus on the disease that is the second largest cancer killer of men in the United States. The good news, however, is that if prostate cancer is caught early, the five-year survival rate is almost 100 percent.

To help observe this special month, we talked with some local experts about prostate cancer, its detection, and its treatment. Here's what they say to help you keep ahead of the game, and possibly avoid prostate cancer.

Am I at higher risk for developing prostate cancer based on my race?

The rate of men getting prostate cancer does vary by race and ethnicity. Roughly speaking, there are three “groups” of risk. The men at highest risk for developing prostate cancer are black men. The men at average risk for developing prostate cancer are white men and Hispanics. The men at low risk for developing prostate cancer are American Indians, Alaskan Natives, Asians and Pacific Islander. The encouraging news is that, for all races and ethnicities, the rate of men getting prostate cancer has decreased over the past decade.

If I have a family history of prostate cancer, should I get checked more often?

Men who have a first degree relative (father or brother) with prostate cancer are more likely to develop the disease. If you choose to have prostate cancer screening, men with average to low risk should begin at age 50. Men with higher risk factors for prostate cancer (such as black men or a man with a father or brother who had prostate cancer) may want to begin screening at age 40 to 45. Once screening has begun, however, there is no difference in how often a patient should get checked.

   Joseph M. Carbone, MD
   Southside Urology & Nephrology
   Danville | 434.792.1433

What are symptoms of prostate cancer?

Prostate cancer gives no symptoms when it is early in its course. Seventy percent of patients have no symptoms at the time of diagnosis. That is why it is important to screen for prostate cancer. A patient can experience difficulty with voiding such as a slow stream, straining to void and urinary retention. When late in the disease, patients can experience pain in the bones weight, hematuria and weight loss.

What are treatment options for prostate cancer?

This depends on the stage and aggressiveness of the individual patient's disease. For localized disease, treatment options include active surveillance, surgery to remove the prostate gland, external beam radiation therapy, radiation seed implant of the prostate and cryotherapy. When it is very early and non-aggressive active surveillance is often recommended which is a planned method of holding off on treatment and monitoring the cancer closely. Surgery removes the entire prostate and thus eliminates the cancer. This is usually done using a laparoscopic robotic technique which is less invasive. External beam radiation is delivering radiation to the prostate from outside the body in a series of approximately 40 treatments. Radiation seed implant, also known as brachytherapy, is a procedure where the radiation source is placed directly in the prostate through an outpatient procedure. Cryotherapy is an outpatient procedure in which the prostate is frozen to try and destroy the cancer. In certain situations, a combination of treatments are used. Androgen deprivation therapy is doing something to take away the male hormone on which the prostate cancer feeds. This is usually done through a shot given once a month. This is the first line treatment for advanced disease but in certain situations it can be used in localized disease in conjunction with other therapies, to make them more successful.

   Robert Cook, MD
   Centra Medical Group Urology Center
   Lynchburg | 434.200.5297

At what age should I start getting a prostate exam? 

For routine screening for prostate cancer without symptoms, the answer is never. Within the last few years, prostate cancer screening tests with digital rectal exams and PSAs have been evaluated and reviewed extensively. Current recommendations do not support routine screening for prostate cancer with PSAs or digital rectal exams.

The reason is because it has been found that these tests do not decrease overall mortality. This may not make sense to many people, but prostate cancer is complicated. For example, 85 percent of men who have elevated PSAs will not die from prostate cancer in a 15 year period. For the majority, prostate cancer is something most can live with, never know about, and will eventually die from something else.

Speak with your doctor about the advantages and disadvantages of screening for prostate cancer. Then, together with your doctor, make an informed decision about whether screening makes sense for you.

   Mark Kleiner, MD
   Central Virginia Family Physicians
   Forest | 434.525.6964

Can prostate cancer be prevented?

Unfortunately, according to the American Cancer Society, prostate cancer cannot be prevented because these risk factors (age, race, and family history) cannot be controlled. But there are some things you can do that may lower your risk of prostate cancer. Keeping healthy servings of fruits and vegetables in your diet, staying physically active, and maintaining a healthy weight can help lower your risk of prostate cancer. Schedule a visit with your local provider to make sure you are on the right track.




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