What Every Man Should Know About Prostate Cancer
Prostate cancer is one of the leading types of cancer in men. In fact, according to The Prostate Cancer Foundation, more than 3 million US men are living with prostate cancer, and in the US, 1 in 9 men will be diagnosed with prostate cancer in his life-time. And for those of African descent, that number is 1 in 7. It is more likely for a man to develop prostate cancer than it is for him to develop colon, kidney, melanoma or stomach cancers combined.
The good news is that this is a cancer that can be treated especially if its detected in the early stages of the disease. Heres what to know about prostate cancer, and the steps you need to take to ensure that youre doing all you can to prevent it .
Prostate Cancer In Young Men
Though older men face the highest risk for prostate cancer, young men are by no means immune. If you’re younger than 60, here’s what you should know about your risk.
Prostate cancer is typically viewed as an old man’s disease. Yes, of the more than 200,000 men who get prostate cancer each year, those who are younger than 60 make up a small proportion, and prostate cancer is extremely rare in those younger than 50. But the reality is that it does occur in young men too.
Vince Market of Philadelphia was diagnosed with prostate cancer two years ago at age 47 and had to have his prostate removed via robot-assisted surgery, a procedure called prostatectomy.
Despite the early prostate cancer diagnosis, Market was lucky. He had been getting tested often because of a family history of the illness, and the robot-assisted surgery was extremely accurate, which helped speed his recovery and reduce complications. “After a five-hour procedure, I was only hospitalized overnight and was fit enough to go back to work within a couple of weeks,” he says. “In fact, I was back exercising by walking five miles a day within that same time frame.”
Some young men with prostate cancer are not as fortunate as Market, but the outcome varies from person to person. Here are the issues you need to know about prostate cancer that develops in younger men.
Whose Prostate Health Is at Risk?
Early Prostate Cancer Diagnosis
Symptoms and Treatment of Early Prostate Cancer
Questions To Ask The Doctor
- What treatment do you think is best for me?
- Whats the goal of this treatment? Do you think it could cure the cancer?
- Will treatment include surgery? If so, who will do the surgery?
- What will the surgery be like?
- Will I need other types of treatment, too?
- Whats the goal of these treatments?
- What side effects could I have from these treatments?
- What can I do about side effects that I might have?
- Is there a clinical trial that might be right for me?
- What about special vitamins or diets that friends tell me about? How will I know if they are safe?
- How soon do I need to start treatment?
- What should I do to be ready for treatment?
- Is there anything I can do to help the treatment work better?
- Whats the next step?
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What Every Guy Needs To Know About Prostate Cancer
Prostate cancer is the second most common cancer among men in America, with about one in eight men diagnosed during their lifetime. It usually occurs in men 65 and older. Generally, doctors suggest that patients begin screenings in their mid-fifties. But if youre predisposed to the illnessprostate cancer is more likely for Black men and anyone with a family history of the diseasethen you should talk to a medical professional about potentially being screened earlier.
According to Dr. Mark Pomerantz, a medical oncologist with Lank Center for Genitourinary Oncology at Dana-Farber Cancer Institute, many people are hesitant to get screened because of the assumption that it entails a digital rectal examination. While checking your prostate that way can be helpful, it hasnt been the primary method doctors use since the mid-nineties. Your doctor is likely to start with a PSA blood test. Additional screening will be necessary if youre levels are high.
Screening is important because many people diagnosed with prostate cancer show no symptoms. Common symptoms including changes in urination, difficulty with erections, and bone aches can also happen to men as they age for reasons that have nothing to do with cancer. By getting screened specifically, youre putting yourself in the best position to catch things early.
How serious is a prostate cancer diagnosis?
What type of treatment will you need?
How likely is remission?
What A Psa Score Really Means For Your Prostate
The best way to know if you have prostate cancer at the earliest possible stage is not the PSA or the digital rectal exam. The best indication is a test called PSA velocity testing.
With PSA velocity testing, its possible to diagnose an early cancer even when the PSA and the rectal exam are normal.
PSA velocity describes how high the value of a mans PSA tests increase in one year. For example, if a you have a PSA test and its 0.5 higher than it was the year before, you have a PSA velocity score of 0.5. If the last time you had a PSA was five years ago, and this years test was 1.0 higher, then your PSA velocity is 0.2, or 1.0 divided by the five years.
As a man ages, due to the normal age-related increase in prostate size, his PSA is likely to rise ever so slightly. But as long as the PSA velocity is minimal, the odds are that if he has a latent cancer, his immune system is still keeping it in check. In fact, a PSA velocity of 0.03 or less per year has been shown to be accurate proof that no prostate cancer exists. Thats an optimal velocity. Although the values may vary slightly from year to year, there should not be any consistent overall increase greater than 0.03.
And all of this is true even if the highest PSA number is still in the normal range. So any PSA velocity greater than 0.15 should be a cause for immediate treatment.
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Myth 5 The Psa Test Is A Cancer Test
Fact. PSA test or Prostate-Specific Antigen test is a diagnostic test that helps detect the levels of prostate-specific antigen in your blood. It is a kind of protein made by the prostate gland and is produced as a response to a number of problems. It could be an inflammation, infection , enlargement of the prostate gland or, even possibly, cancer.
Think of the PSA as a first alert smoke alarm, instead of a fire alarm. The PSA test may be the first step in the diagnostic process for cancer. It has made detection of cancer in its early stages easier, improving the prognosis.
Image credits- freepik
What Is Stereotactic Body Radiation Therapy And What Advantages Does It Offer
Traditionally, we deliver external beam radiation in 45 to 48 sessions over a span of ten weeks, using very sophisticated computer-based planning and enhanced imaging techniques and tumor tracking during the treatment. This is called image-guided IMRT and it is the current standard of care.
But there is increasing interest in giving this radiation in shorter courses of treatment. Many of the people we care for have a type of radiation therapy called MSK PreciseTM. MSK Precise is a form of SBRT that can be given in five sessions instead of the usual 45 to 50. MSK has been doing this for the past nine years, and the results in the several hundred people whove been treated have been excellent so far. The treatment is very well tolerated, with outcomes that are at least equivalent to and possibly better than the standard ten weeks of treatment. Because of its superior precision, MSK Precise has less side effects than more conventional radiation techniques, with extremely low rates of incontinence and rectal problems. The sexual side effects are low and similar to what is experienced with conventional external radiation techniques. And of course, its much more convenient for patients.
For patients with more-advanced tumors, we are completing a phase II trial in which were combining sophisticated brachytherapy approaches with MSK Precise. This kind of combination of dose-intense or escalated radiation may end up being a very effective regimen.
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Half Of Men Over 60 Have Prostate Cancer But Most Die Of Other Causes
A new study looking at the prevalence of prostate cancer in men over 60 years of age found that just about 50 percent of men have the cancer. This statistic isn’t as distrubing as it sounds most prostate cancers never develop into a harmful form of the disease and a large proportion of men will pass away from other causes without their prostate cancer progressing and becoming invasive.
The current study, published in the Journal of the National Cancer Institute, examined 320 men from Russia and Japan who had died at the age of 60 or older between 2010 and 2011. None of the men had been diagnosed with prostate cancer before their death. Men from Russia were used for the survey because they have similar fat intakes and sun exposures compared to North American men. Japanese men were examined because the incidence of prostate cancer is lower in the male population of Japan, most likely resulting in different diet compared to Caucasian North American men.
How often men should be tested for prostate cancer is a topic of debate among healthcare professionals. After all, the bottom line is that most American men will get prostate cancer if they live long enough. But many of them never experience any ill effects from the cancer, and typically die of natural causes having nothing to do with the prostate. And in fact, many doctors believe that prostate cancer is over-treated because not all men progress to a dangerous form of the disease.
Can Prostate Cancer Treatment Affect Your Quality Of Life
Your age and overall health will make a difference in how treatment may affect your quality of life. Any health problems you have before youre treated, especially urinary, bowel or sexual function problems, will affect how you recover. Both surgery and radiation can cause urinary incontinence or impotence .
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Risk Factors In Aggressive Vs Slow
In the past few years, weve learned that prostate cancer really is several diseases with different causes. More aggressive and fatal cancers likely have different underlying causes than slow-growing tumors.
For example, while smoking has not been thought to be a risk factor for low-risk prostate cancer, it may be a risk factor for aggressive prostate cancer. Likewise, lack of vegetables in the diet is linked to a higher risk of aggressive prostate cancer, but not to low-risk prostate cancer.
Body mass index, a measure of obesity, is not linked to being diagnosed with prostate cancer overall. In fact, obese men may have a relatively lower PSA levels than non-obese men due to dilution of the PSA in a larger blood volume. However, obese men are more likely to have aggressive disease.
Other risk factors for aggressive prostate cancer include:
- Tall height
- Agent Orange exposure
Research in the past few years has shown that diet modification might decrease the chances of developing prostate cancer, reduce the likelihood of having a prostate cancer recurrence, or help slow the progression of the disease. You can learn more about how dietary and lifestyle changes can affect the risk of prostate cancer development and progression in PCFs Health and Wellness: Living with Prostate Cancer guide.
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How Do Men Feel About The Rectal Exam
I think most men are willing to do it, but some men are exceptionally opposed to it. They might be happy to hear that there are studies ongoing in the United Kingdom looking at using magnetic resonance imaging as a screening tool to be able to avoid doing a digital rectal exam in the future. There is a large African immigrant population in London with a higher incidence of prostate cancerthey didnt want to have the prostate exam because they had a lot of opposition to it. They were uncomfortable with it.
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Your Risk For Prostate Cancer
The greatest risk factors for developing prostate cancer are increasing age, family history, ethnicity, and diet. Do any of the following describe you?
- I am older than 50
- I have a family history of prostate cancer
- I am African-American
If you answered yes to any of these, then you may be at higher risk of prostate cancer. However, not having any of these risk factors does not mean you are immune. Unfortunately, all men are at risk for prostate cancer. Keep reading to learn more about your risk and what steps you can take.
How Does The Doctor Know I Have Prostate Cancer
Prostate cancer tends to grow slowly over many years. Most men with early prostate cancer dont have changes that they notice. Signs of prostate cancer most often show up later, as the cancer grows.
Some signs of prostate cancer are trouble peeing, blood in the pee , trouble getting an erection, and pain in the back, hips, ribs, or other bones.
If signs are pointing to prostate cancer, tests will be done. Most men will not need all of them, but here are some of the tests you may need:
PSA blood test: PSA is a protein thats made by the prostate gland and can be found in the blood. Prostate cancer can make PSA levels go up. Blood tests will be done to see what your PSA level is and how it changes over time.
Transrectal ultrasound : For this test, a small wand is put into your rectum. It gives off sound waves and picks up the echoes as they bounce off the prostate gland. The echoes are made into a picture on a computer screen.
MRI: This test uses radio waves and strong magnets to make detailed pictures of the body. MRI scans can be used to look at the prostate and can show if the cancer has spread outside the prostate to nearby organs.
Prostate biopsy: For a prostate biopsy, the doctor uses a long, hollow needle to take out small pieces of the prostate where the cancer might be. This is often done while using TRUS or MRI to look at the prostate. The prostate pieces are then checked for cancer cells. Ask the doctor what kind of biopsy you need and how its done.
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Can Multivitamins Cause Prostate Cancer Or Any Cancer At All
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What Questions Should I Ask My Healthcare Provider
If you have prostate cancer, you may want to ask your healthcare provider:
- Why did I get prostate cancer?
- What is my Gleason score? What is my Grade Group? What do these numbers mean for me?
- Has the cancer spread outside of the prostate gland?
- What is the best treatment for the stage of prostate cancer I have?
- If I choose active surveillance, what can I expect? What signs of cancer should I look out for?
- What are the treatment risks and side effects?
- Is my family at risk for developing prostate cancer? If so, should we get genetic tests?
- Am I at risk for other types of cancer?
- What type of follow-up care do I need after treatment?
- Should I look out for signs of complications?
A note from Cleveland Clinic
Prostate cancer is a common cancer that affects males. Most prostate cancers grow slowly and remain in the prostate gland. For a small number, the disease can be aggressive and spread quickly to other parts of the body. Men with slow-growing prostate cancers may choose active surveillance. With this approach, you can postpone, and sometimes completely forego, treatments. Your healthcare provider can discuss the best treatment option for you based on your Gleason score and Group Grade.
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Is Prostate Removal A Major Surgery
Sometimes, a mix of both treatments works best.
- Hormone therapy. Prostate cancer cells need male sex hormones, like testosterone, to keep growing.
- Cryotherapy. If you have early prostate cancer, your doctor might choose to kill cancer cells by freezing them.
Inherited Risk Of Prostate Cancer
Over past decades, scientists have learned that some prostate cancer that runs in families is hereditary. In these cases, mutations in genes that raise the risk of prostate cancer occur in every cell of the body and are passed on from either a mother or father to a child, said Elias Obeid, MD, MPH, medical oncologist and director of the Prostate Risk Assessment Program at Fox Chase Cancer Center.
These inherited alterations in genes may be responsible for up to 10 percent of all prostate cancers, according to the American Cancer Society, and often occur in genes that repair damage to DNA, including BRCA1 and BRCA2 genes.
Mutations in these two genes are best known for causing breast and ovarian cancer in women. But they also raise prostate cancer risk in men who inherit them, especially faulty BRCA2 genes, which are tied to aggressive prostate cancer, Obeid said.
Other genes that can cause prostate cancer through mutations include those related to DNA repair, such as CHEK2 and ATM HOXB13, which is related to the development of the prostate gland and the genes tied to a disease called Lynch syndrome.
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