You’ve probably heard jokes or perhaps even told a few about getting a prostate test or going for a prostate cancer screening. But considering that one in six men in the United States will be diagnosed with prostate cancer, getting a prostate test is no laughing matter.
Let’s face it: people poke fun at the prostate (pun intended). And while it’s okay to make a few jokes, prostate cancer, like a prostate cancer screening, is no laughing matter. One reason people make jokes about the prostate test is that one part of the process involves a less than dignified but very brief examination called a digital rectal examination (DRE). If you’re a guy who has not yet had a DRE, I explain it below. For now, just let me say that if getting a DRE is your reason for not getting your prostate checked, then it’s time you took a deep breath and just did it. Hey, every guy who goes into the military has had to cough or strain while a doctor felt his groin, so if they can do that, you can get a DRE is all I’m saying. Forget the jokes, learn all you can about prostate tests and prostate cancer, and then make an informed decision about getting screened.
Despite the fact that prostate cancer is the second most common type of cancer among men in the United States and is estimated by the National Cancer Institute to kill more than 32,000 US men in 2010, prostate cancer screenings do not get the amount of press or respect–that breast cancer screenings do. Don’t get me wrong: screening for breast cancer is extremely important and every woman should discuss screening with their physician and heed his or her recommendations.
But prostate screening is critically important too. True, the prostate gland is not as glamorous or sexually appealing as breasts nor is it visible to remind us that it’s there, but it performs various important functions, including making some of the fluid for semen, keeping urine out of the semen, and enhancing pleasurable sensations of arousal and orgasm. You also want to keep the prostate healthy because if it become infected or enlarged, it can seriously impact urinary and sexual functioning. Therefore maintaining prostate health is of utmost importance, and undergoing prostate tests is one way to do it.
Doctors and other experts do not all offer the same recommendations for prostate cancer screening, although the Food and Drug Administration (FDA) has approved the use of the PSA test along with the DRE to help detect prostate cancer in men 50 years and older. Some say men older than 50 should be screened every year, while others recommend men who are at higher risk for prostate cancer to begin screening at age 40 or 45. (Risk factors include age, a family history of prostate cancer – especially a brother or father, being African American, a high-fat diet, obesity, lifestyle and other factors such as exposure to chemicals and toxins.) Other experts say routine prostate tests are not necessary.
The point is, every man needs to have a prostate test at some point, and that point differs for each man. Therefore you should work with your physician and consider your unique state of health, along with the risk factors already mentioned, and the fact that age is the most common risk factor, with nearly 63 percent of cases occurring in men age 65 and older.
Prostate cancer screening typically involves two procedures. One is the digital rectal exam, during which a doctor inserts a gloved, lubricated finger into the rectum. It takes about a minute or so for the doctor to feel the prostate through the wall of the rectum and to check for any suspicious lumps, as well as for any abnormalities in the glands shape or size. While it is not the most comfortable procedure you will ever experience, it usually is not painful and is over rather quickly. (By the way, women also have DREs to check for abnormalities in their reproductive organs. DREs are also used to check for colon polyps.)
The prostate-specific antigen (PSA) test involves taking a small blood sample and having it tested for the level of the antigen. PSA is a substance produced mostly by the prostate that may be present in elevated amounts in men who have prostate cancer. However, high PSA levels can also be an indication of noncancerous conditions, such as an enlarged prostate (benign prostatic hyperplasia, or BPH) or prostatitis.
Prostate tests are not foolproof, however, so you should have a discussion with a trusted, knowledgeable healthcare provider to determine the best time for you to be screened. During that discussion your healthcare provider should inform you about the risks of prostate screening.
As with most tests, prostate tests run the risk of providing false-negative or false-positive results. If you receive a false-negative test results (one that shows you do not have cancer when you really do), then you may delay seeking treatment even if you have symptoms. A false-positive result means your test appears to be abnormal even though you don’t have cancer. Such results could send you on an unnecessary route of more tests, including a biopsy, and the risk of complications, which include fever, pain, blood in the semen or urine, and urinary tract infections.
A common risk associated with prostate tests is if your PSA test shows an elevated level, your doctor may recommend you have a biopsy of the prostate to help determine whether you have cancer. He or she may recommend a biopsy because a man’s PSA level alone does not provide enough information to distinguish between a noncancerous prostate condition and prostate cancer. A biopsy, however, is associated with complications, as I have already noted.
If the biopsy indicates that you do not have cancer, then that’s great news, and you can explore other reasons why your PSA levels are high, such as an infection, BPH, or prostatitis. But having had the biopsy, you still run the risk of experiencing the complications. If the biopsy indicates that you do have prostate cancer, then you and your healthcare provider will need to discuss whether you should undergo treatment. According to prostate cancer researcher Arul Chinnaiyan, MD, PhD, the SP Hicks Collegiate Professor of Pathology at the University of Michigan Medical School, the PSA test is responsible for hundreds if not thousands of unwarranted biopsies a year, and ultimately overtreatment of incidental [cancers]. (WebMD) This is all food for thought and discussion with your physician.
Another risk factor associated with prostate tests is that thus far, there is no scientific proof that undergoing these tests improves your health or will help you live longer if you do have cancer. In fact, a multicenter study that included more than 71,000 men found no evidence that screening with PSA and DRE is effective in reducing the risk of death from prostate cancer. (Concato et al)
If the tests indicate you do have prostate cancer, then the good news is that you have identified it and you can now take steps to deal with it. Some prostate cancers do not cause symptoms or become life-threatening, and so doing nothing”except monitoring the situation regularly with repeat PSA tests, a process known as watchful waiting”may be all that is necessary. Prostate cancer tends to be a slowly progressive disease, and very slow-growing tumors are unlikely to threaten a man’s life. Therefore treating these men with surgery, radiation, or hormone therapy, all of which may cause serious side effects, would unnecessarily disrupt their quality of life.
If you’re a guy, or if you’re a woman who has a man in her life who has not taken any steps toward having his prostate tested, then it’s time to consider a few factors:
- One in six men develop prostate cancer is that one you? Talk to your healthcare provider about when you should have your prostate tests. Now may not be the time to have your PSA and DRE, but it is time to plan ahead.
- If you get prostate cancer, your life will never be the same, no matter what you read or people tell you. Research suggests that a healthful diet that is rich in antioxidants such as lycopene, quercetin, catechins, and procyanidins, may help protect against prostate cancer. (Konijeti; Jung; Reagan-Shaw) This is a step men can start at any age! You are never too young to reduce your risk of cancer through positive modifications to lifestyle, diet, exercise, stress-management, weight loss and nutrition as well as hormone and inflammation management, consuming limited dairy products and avoiding foods, additives and supplements that may contribute to prostate cancer. And while there is nothing that can “prevent” prostate cancer, this does not mean you shouldn’t do all you can to reduce your risk, no matter what age you are.
- Even if you think you’re too young to be tested, think again: prostate cancer can affect men in their thirties. Statistics from 1998 to 2002 found that the median age at diagnosis was 68 years, yet 0.5 percent of men between 35 and 44 were diagnosed with the disease, and 8.3 percent were between 45 and 54 at the time of diagnosis. (emedtv) And more and more evidence is showing that the positive effects of antioxidants is only being seen when commenced in your 20?s and early 30?s so it’s important to start eating healthy and taking positive lifestyle steps no matter what age you are.
- Think about adding to your diet and nutritional program with supplements like lycopene, quercetin, omega 3, mushroom extract, curcumin (turmeric), vitamin D, resveratrol, pectin, green tea, cayenne (capsaicin) that all have tier 1 and tier 2 clinical (human and animal) trials supporting their effectiveness in boosting immunity and causing apoptosis (self destruction) of cancer cells. And be cautious about supplements that may contribute to prostate cancer such as calcium and excessive folic acid/folate intake from supplements (as opposed to diet). Note also that daily multivitamin use has been linked to a higher risk of prostate cancer.
The bottom line. Talk to your doctor today and if it’s the right decision for you then “Man Up” and get tested. The earlier the detection, the better your treatment options and overall post-treatment quality of life.
It’s a sunny summer day. You’re sitting by the pool, eating a non-organic apple, drinking bottled water and talking on your cell phone. Which of these is most likely to increase your risk of cancer?
Despite recent concerns about plastics, pesticides and cell phones, it turns out sitting may be the greatest risk factor, especially if you sit for long periods of time. Physical activity burns calories, and the more calories we expend, even by standing, the less likely we are to gain weight. According to the American Cancer Society, being overweight or obese is clearly linked with an increased risk of developing several types of cancer, including cancers of the breast, colon, uterus, esophagus and kidney.
If you are a cancer survivor who struggles with the very common fear of cancer recurrence, or you have a family history of cancer, where do you start?
Steer clear of the freebie pedometers given out at health fairs and invest in a quality device that syncs with your computer. You can find a good one for less than $40. Then wear it every single day. Track your daily steps for one week to find out your baseline, and then set a goal each week to increase your steps by 500 to 1000 per day until you reach 10,000 steps per day. If you are in the midst of cancer treatment, 10,000 steps may seem overwhelming, but there is substantial evidence that increasing physical activity during treatment helps reduce fatigue.
Not only will you raise money for a good cause, but the training program will also get you moving. If you have never done a race before, start with a 5K (3.1 miles). Running is not required – the goal is to get you moving.
Replace your TV watching habit with physical activity. Set the DVR for your favorite shows then spend your evening in your garden, playing with your children or your dog, or going for a long walk. When you must watch your favorite show, limit TV time to no more than 60 minutes and get up from the couch at each commercial break to walk around the house, do squats or do sit ups.
If you work at a desk job, get up from your desk every hour to take a break. Use your cell phone alarm, or set a reminder in Outlook as a reminder to move. Walk to a coworker’s office instead of emailing, step outside for some fresh air, or take a lap around the parking lot.
If you are currently in the midst of cancer treatment, this may be difficult, but if you are through treatment and work at a desk job all week, maximize your activity on the weekend. Go for walk at a local park, swim at the lake or pool, bike with your family, or work in your garden.
Integrative Oncology is an important part of patient care at Radiotherapy Centers of Georgia.
Abiraterone, 4th New Drug for Prostate Cancer is Approved in 12 Months
In the past few months I have often said there is no better time to be a prostate cancer patient than now. In my position here at the Prostate Cancer Foundation, I have uttered this statement with enthusiasm and a bit of pride. As a patient, I have said it with a healthy portion of relief and a prayer of thanksgiving for progress. Not that I want to ever need any of these new drugs, but, as I grapple with my disease and the ever present possibility of recurrence, I am reassured that these new treatments will be ready and waiting for me and my medical team if and when I need them.
To recap, the four new drugs are: Provenge (the first ever immunotherapy for the disease); Cabazitaxel, an advanced chemotherapy agent also known as Jevtana; Denusomab, marketed as Xgeva for bone health during androgen dperivatrion tehrapy; and now, Abiraterone (Zytiga). Approved just yesterday by the FDA, Abiraterone has been in development since the 1990s and will be utilized for the treatment of castration-resistant, metastatic prostate cancer following docetaxel chemotherapy. It’s a clinical break-through for patients who previously had few good clinical therapies available to them.
During Phase III clinical studies, patient response was so encouraging that those patients who were taking the placebo were given the option of switching to the drug. Good news indeed for so many.
You can read more about Abiraterone here.
Here’s to progress. Here’s to better outcomes.
We Often Consider at What Age a Man Should Consider PSA Screening, But We Rarely Ask When Do Individuals Stop?
I just had an interesting conversation with an individual who asked me at what age do most men start thinking about NOT having an annual PSA test? To be honest, I didn’t have an immediate answer. It’s a complicated question and I am, to be honest, stumped. Age is certainly a factor as is the reality that there exist 24 types of prostate cancer that range from indolent to very aggressive.
We frequently read about suggested guildelines for PSA screening. I personally like the AUA recommendation that suggests a man should talk to to his doctor about a first screening to establish a baseline when he enters his 40s. From there, based on a man’s general state of health and family history, he can decide on a screening approach that is right for him. But in the almost twelve months that I have been writing this blog and the years that I have been meeting fellow patients, I can’t remember a discussion that addresses the other end of the spectrum. I would think that a vibrant, active 78-year-old man with a form that appears to be aggressive would be grateful to have the data and take some sort of action. Of course, a man of the same age could be pleased to live out his life with little or no intervention if his numbers indicated a slower growing form of cancer that he could quite possibly live with. But, how many give up, for whatever reason, wanting to know at all?
So, I have to ask four questions:
1.) Are there men out there in their 70s and 80s who choose to no longer have annual PSA screenings and why?
2.) Are there men out there in their 70s and 80s who insist on annual PSA screenings?
3.) Are there men in this age group who have been screened and diagnosed with cancer?
4.) If you were given a diagnosis of cancer in your 70s or 80s, what course of treatment did you decide upon?
Thank you to anyone and everyone who can provide some insight.
ATLANTA – As a culmination of the efforts behind the Prostate Cancer Awareness Pledge Campaign, there will be a prostate cancer symposium on Saturday, April 2, 2011 held at the Morehouse School of Medicine located at 720 Westview Drive SW, Atlanta, GA 30310 from 10 a.m. until 3 p.m.
Prostate cancer is a serious health concern in Georgia. According to the American Cancer Society, the state of Georgia ranks 11th in number of estimated deaths per capita from the disease.
The Georgia Prostate Cancer Coalition, RC Cancer Centers, Atlanta Hawks, Atlanta Thrashers, UPS, CR Bard, WXIA Television, Morehouse School of Medicine, KISS 104.1 Radio and WSB Radio partnered in support of the challenge for 10,000 men in Georgia pledge to have the conversation with their doctors and/or be screened by April 30, 2011.
The campaign launched in December with a gathering of partners and officials with Mayor Kasim Reed as he signed a pledge card to have a conversation with his doctor and/or be screened for prostate cancer. On Monday, March 14, 2011, legislators from the Georgia House and Senate gathered to sign pledges and got screened for prostate cancer as they recognized Prostate Cancer Awareness Day at the capitol.
“We’ve made great strides in the last few months but still have a ways to go in the mission to raise awareness about prostate cancer in Georgia,” said Frank Catroneo from the Georgia Prostate Cancer Coalition.
The Prostate Cancer Symposium will be divided into two sessions. The morning session for physicians only will begin at 7:30 a.m. and features a panel discussion on public health trends, informed decision making for prostate cancer, outcomes and the impact of health policy impact on prostate cancer. Attending physicians will be eligible for CME credits.
The second session which begins at 10 a.m., is free to the public and will educate and empower men, providing information to support better prostate cancer treatment decision making and raise general awareness. Moderated by Jerry Carnes of WXIA 11 Alive, the day’s program includes several renowned speakers including Jonathan Simons, M.D., president and CEO of the Prostate Cancer Foundation, James Bennett, M.D., Morehouse School of Medicine faculty, Ingrid Hill, Ph.D., MPH from the Centers for Disease Control and Prevention as well as James Benton, M.D., radiation oncologist from RC Cancer Centers.
The Georgia Department of Community Health reports prostate cancer is the leading cause of cancer among Georgia males and accounts for 28 percent of all new cancer cases among males each year. Other than skin cancer, prostate cancer is the most common cancer in American men and the second leading cause of cancer death, behind lung cancer according to the American Cancer Society.
A prostate screening PSA (Prostate Specific Antigen) is a simple blood test which will not define a man’s prostate cancer status, but provides the basis for men to start the right conversations with their doctor. When prostate cancer is detected early, it is a very curable disease.
“Maintaining an ongoing relationship with our healthcare providers is an essential part of preventive care when discussing prostate cancer because risks vary from person to person,” said Dr. Roland Matthews, from Morehouse School of Medicine and Director of the Grady Cancer Center for Excellence.
“As the campaign continues through the next few weeks,” said Michael Holton, president and COO of RC Cancer Centers. “RC Cancer Centers continues to offer free of charge PSA screenings for men over 40 years old. They can be screened at any one of our five locations in Georgia. For screening locations, visit www.GeorgiaProstateCancerPledge.com .”
Nationally, about one in six men will be diagnosed with prostate cancer during their lifetime. Prostate cancer is treatable when caught early.
To register for the Prostate Cancer Symposium visit www.GeorgiaProstateCancerPledge.com or contact Shelly Glenn at 770-682-2099 x. 119 or firstname.lastname@example.org.
To learn more about the Prostate Cancer Pledge Campaign, visit www.GeorgiaProstateCancerPledge.com.
We meet them every week, and they are amazing.
Granted, every patient confronted with a serious disease is a hero in their own right. Given a life-altering, possibly life-threatening, scenario, they step up to the plate, find ways to cope with their fears and sign up for various physically-demanding treatments all at a time when they could actually be forgiven for wanting to, as the saying goes, curl up and die. It’s a testament to their families, friends and their own perceived self-worth. It’s also an odd but very real way of celebrating life itself.
But there are other heroes that never cease to amaze me. In my circles, I call them the undiagnosed cancer heroes. Individuals who have not been given their own diagnoses, but have thrown themselves squarely into the front lines of this battle. They are advocates, researchers, family members and friends who continue to perform heroic deeds on our behalf. Last week I met with several researchers and cancer advocates in Boston and London and was, as always, impressed by their unwavering passion for the cause. One British woman in particular sticks in my mind.
Meet Wendy Gough.
Wendy lost her son, Matthew, to testicular cancer when he was just 19 years old. Before he died, he told her: “I learnt so much in school that I would never use in my life, but the one vital thing that might have saved my life, they didn’t teach me.” It was an unnecessary loss, particularly since, as LIVESTRONG has taught us, testicular cancer is highly treatable, perhaps even curable. But what Matthew was missing, was the basic information about the problem, how to spot it and how to self examine. He watched, ashamed and afraid, as a tumor took shape. By the time Matthew decided to speak up and see a doctor, it was too late to contain his cancer.
As a parent, I can image the pain and loss that Wendy encountered when Matthew succumbed to the cancer that had invaded his body. One would be very sympathetic if she had merely mourned and tried to get on with her life without a vital limb. Yes, a child implants itself on a parent like a third and very essential arm. Instead, in the 12 years since Matthew’s death, Wendy has gone on the offensive.
Wendy initiated Cancer Awareness Talks,which she delivers personally, to schools across Britian. She has pounded the halls of Parliament to enourage the adoption of a cancer curriculum in all schools and made numerous media appearances to tell of Matthew’s story and the need for increased awareness and self examination. She has also spent her entire inheritance–sans regrets–in doing so. Fortunately, she now has the support of several Charitable Trusts on her side of the pond.
Wendy’s efforts have been directly credited with saving hundreds of lives in the U.K. Professor Tim Oliver from Bart’s Hospital in London reports: “The size of (testicular) tumors over the past decade have now halved on presentation because cancer awareness is at last getting attention–at last we feel that somebody is listening to what we have been attempting to tell them for 12 years.”
Last year, through the Everyman Cancer Awareness Support Group, Wendy covered 23 counties and 250 schools, reaching more than 30,000 school children. She also gave talks to the British armed forces and police departments. I believe Wendy will soon see her goal ensuring that cancer curriculum become mandatory in the British school system. It will promote awareness for all cancers.
Yes. We are surrounded by heroes, embraced by angels on earth. Wendy is one of them.
Note:You can read Darren Couchman’s testicular cancer blog, One Lump or Two? at http://www.onelumportwo.org.uk/index.htm
Dr. Merlin, of RC Cancer Centers, discusses prostate cancer and answers many common questions relating to the topic.
It’s surprising how landmark deep science can be supported by deeply rooted fun like Movember.
Researchers have sequenced the genomes of prostate tumors from seven men–a landmark event that promises to one day help clinicians learn how to differentiate between those tumors that will be highly aggressive and require immediate treatment and those that are essentially benign and that can be simply observed through proactive surveillance. This project represents a transforming moment in understanding the underlying biology of prostate cancer.
Geneticists have been sequencing a variety of tumors of different types, but the effort on prostate tumors introduces a new level of complexity. If the data for each genome were presented in the form of a printed telephone book, it would form a book 35 feet high.
All of this is deeply complicated science, indeed. And it’s promising news for millions of prostate cancer patients. But it is important to note that is was made possible by an entirely fun–even frivolous–annual campaign known as Movember. Each year, thousands of men around the world grow moustaches to raise funds that support crucial research that can ”change the face of men’s health.” In the case, whole genome sequencing of prostate cancer was made possible by unrestricted funds raised by Movember in the U.S. and donated to PCF.
What really surprised the researchers, said geneticist Levi Garraway from the Dana-Farber Cancer Institute, was the wholesale shuffling of large segments of the genomes, with relatively big chunks of DNA broken out from one site and reinserted elsewhere. The team found more than 100 such rearrangements, far more than had been observed in any other form of cancer studied so far. “Not only were they much more common than one might have imagined, but there were certain patterns,” Garraway said. “It’s important for prostate cancer, but it might be telling us something fundamental about how cancer genomes become messed up in the first place.”
Complete information on this historic sequencing of whole prostate cancer genomes can be found at PCF’s website.
Men of America: Grow on!
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