Prostate Cancer: What Every Man Should Know
According to the National Cancer Institute (NCI), men in the United States get prostate cancer more than any other type, with the exception of skin cancer.
One in five men in the U.S. will be diagnosed with prostate cancer. It is the second leading cause of death from cancer in men.
Prostate cancers are primarily adenocarcinomas, which are cancers that begin in cells that make and release mucus and other fluids. Prostate cancer usually grows very slowly and often has no early symptoms. Advanced prostate cancer can cause men to urinate more often or have a weaker flow of urine, but these symptoms can also be caused by benign prostate conditions.
The three most significant risk factors for prostate cancer are age, race (African American men are at a higher risk) and family medical history. Several studies have shown a correlation between family medical history and prostate cancer cases.
“A man with a father or brother who developed prostate cancer is twice as likely to develop the disease,” says Dr. Garrett Korrect, McFarland Clinic urologist. “Risk also increases if there are multiple immediate family members who have been diagnosed with prostate cancer and if those family members were diagnosed at younger ages.”
Men are often diagnosed as the result of health screenings, such as a blood test for a substance called prostate specific antigen (PSA) or a digital rectal exam.
Monitoring prostate health involves asking men questions about urinary patterns and symptoms, asking about family history of prostate, cancer and performing prostate examinations to assess for prostate size and presence of nodules or other abnormalities, says Korrect.
“When a man is referred to me with an elevated PSA or abnormal prostate examination we assess this information as well as their general health and personal preferences. If this information leads us to believe that the risk of clinically significant prostate cancer is high enough we then decide to proceed with a prostate biopsy,” says Korrect. “The decision to treat someone for prostate cancer depends on the grade, or aggressiveness, of the cancer, symptoms that may be associated with the cancer, patient age and general health, and patient preference. We know there are some prostate cancers that can be safely monitored without treatment for many years, if not indefinitely.”
The American Urological Association (AUA) recently released recommendations for who benefits the most from prostate cancer screening. Screening usually involves a prostate exam and PSA testing. According to the AUA, screening is most beneficial to men between the ages of 55-69. The decision to screen patients younger than that age is based on patient preference, family history and risk factors, including race (African American men are more at risk).
The decision to screen patients older than 69 also depends on risk factors for prostate cancer, general medical health and patient preference. Prostate cancer screening is rarely recommended for men under 40 years of age.
Prostate cancer treatment options include radiation therapy and surgery. Radiation therapies, including high dose rate brachytherapy, are provided at Mary Greeley’s radiation oncology unit. Korrect and his colleague, McFarland Clinic urologist Dr. Damon Dyche, perform robotic-assisted prostatectomies for patients to choose to undergo surgery for prostate cancer.