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.
With the identification of more than 25 types of prostate cancer by PCF-funded scientists in the past 24 months, and the fact that it remains one of the least talked about cancers, it’s no wonder there remains a great deal of confusion surrounding this disease.
Ask any group of men about prostate cancer. If they don’t abruptly change the subject or take the opportunity to crack a few wise remarks, chances are you will get a wide variety of answers when it comes to what it is, how it should be treated and whether or not (and when) one should be screened for this disease. Against this reality, it is always a good idea to review some of the more popular myths and misconceptions about this disease that claims the lives of more than 32,000 men in the U.S. each year.
While it may be true that the older you are, the more likely you are to be diagnosed with prostate cancer (65% of cases are diagnosed in men who are 65 or older), the fact remains that 35% of those diagnosed, or more than 76,000 each year, are diagnosed at an earlier age. I was diagnosed at age 51 and I have met many men who were diagnosed in their early 40s. Although only 1 in 10,000 men under age 40 will be diagnosed, the rate skyrockets up to 1 in 38 for ages 40 to 59, and 1 in 15 for ages 60 to 69.
There are many risk factors to consider. Your race, family history, physical health and lifestyle—even geographic location—are all factors that can increase your likelihood of developing prostate cancer.
Wrong. Prostate cancer is one of the most asymptomatic cancers in oncology, meaning not all men experience symptoms. Many times symptoms can be mistaken or attributed to something else. Signs of prostate cancer are often first detected by a doctor during a routine check-up. Common symptoms include a need to urinate frequently, difficulty starting or stopping urination, weak or interrupted flow of urination, painful or burning urination, difficulty having an erection, painful ejaculation, blood in the urine or semen, or frequent pain and stiffness in the lower back, hips or upper thighs. If you experience any of these symptoms, be sure to tell your doctor.
The answer to this one is sometimes, yes. Sometimes, no. With the 25 types of prostate cancer discovered by PCF-supported researchers, we can confirm that there are those prostate cancers a man may die with and not of, while others are very aggressive. Once a biopsy confirms the presence of cancer in the prostate, a physician uses the data contained in the pathologist’s report to characterize the potential aggressiveness of the cancer and make recommendations for treatment based on many factors, including a patient’s age and health status. There are many treatments available for patients and one approach does not fit all cases. Patients need to understand the complexity of this disease and make treatment decisions that are right for them in consultation with a trusted medical professional.
The good news is that we believe, with the accelerated pace of scientific discovery, we will soon be able to identify the specific cancer a patient has at time of their diagnosis and match the most effective treatments for their prostate cancer and their biological makeup. This will enable us to cure more and overtreat less.
Wrong. While a family history of prostate cancer doubles a man’s odds of being diagnosed to 1 in 3, the fact remains that 1 out of 6 American men will be diagnosed with prostate cancer in their lifetime. This compares to 1 in 8 women who will be diagnosed with breast cancer. African-American men are 60% more likely to be diagnosed with prostate cancer and 2.4 times more likely to die as a result.
Family history and genetics do, however, play a role in a man’s chances for developing prostate cancer. A man whose father or bother had prostate cancer is twice as likely to develop the disease. The risk is further increased if the cancer was diagnosed in a family member at a younger age (less than 55 years old), or if it affected three or more family members.
In 2010, approximately 218,000 new cases were diagnosed in the U.S. and more than 32,000 men died as a result of this cancer. The number of new U.S. cases could exceed 300,000 per year by 2015.
Incorrect. The PSA tests measures levels of prostate-specific antigen in the prostate, not cancer. PSA is produced by the prostate in response to a number of problems that could be present in the prostate including an inflammation or infection (prostatitis), enlargement of the prostate gland (benign prostatic hyperplasia) or, possibly, cancer. Think of it as a first alert smoke alarm, instead of a fire alarm. The PSA test is the first step in the diagnostic process for cancer. It has made detection of cancer in its early stages, when it is best treated, possible. Experts believe the PSA test saves the life of approximately 1 in 39 men who are tested. Personally, I believe the PSA test saved my life and will continue to save it as we track my response to treatment.
Although prostate cancer is a common cause of elevated PSA levels, some men with prostate cancer may even have low levels of PSA. PSA can also be diluted in men who are overweight or obese, due to a larger blood volume, and a biopsy should be considered at a relatively lower number (i.e. 3.5 instead of 4). Again, elevated levels can be an indication of other medical conditions.
Having a vasectomy was once thought to increase a man’s risk. This issue has since been carefully researched by epidemiologists. Vasectomy has not been linked to increasing a man’s chance of getting prostate cancer but has led to the prostate being checked by the urologist more often and prostate cancer consequently being detected in the clinic.
While erectile dysfunction (ED) and urinary incontinence are possibilities following surgery or radiation therapy for prostate cancer, it is not true that all men experience complications. These side effects can also be highly dependent on age and physical condition. Numerous therapies and aids can improve erectile function and limit incontinence following treatment and nerve sparing surgical procedures have improved outcomes for patients as well. When selecting a surgeon, patients should inquire about the surgeon’s outcomes for ED and incontinence as well as the number of surgical procedures (open or robotic) performed.
High levels of sexual activity or frequent ejaculation were once rumored to increase prostate cancer risk. In fact, some studies show that men who reported more frequent ejaculations had a lower risk of developing prostate cancer. Ejaculation itself has not been linked to prostate cancer.
Prostate cancer is not infectious or communicable. This means that there is no way for you to “pass it on” to someone else.
The first step in dealing effectively with prostate cancer is knowing the facts and eliminating confusion. Recent studies have shown that lifestyle decisions such as maintaining a healthy diet and regular exercise, such as walking 30 minutes a day, may also play a pivotal role in reducing the risk of getting prostate cancer and surviving it if you get the disease. Talk to your family and friends about prostate cancer and, if you are over 40, talk to your physician to develop a prostate health and screening plan that is right for you.
By Dan Zenka
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.
A new study shows nearly half of men feel worse after having their prostate gland removed due to cancer, although three-quarters would do it again given the same circumstances.
Tens of thousands of men each year undergo the surgery, called prostatectomy, and may suffer long-term consequences to their quality of life, in particular sexual function.
In the current study, published in the Journal of Urology, researchers asked 236 men how they were doing up to 1 year after surgery.
Three out of four had regained their physical and mental well-being and had no more problems with incontinence than before the operation. But just one out of four had recovered his ability to have intercourse.
The research team, led by Dr. Adrian Treiyer at St. Antonius Hospital in Eschweiler, Germany, also teased out the circumstances that were tied to better recovery.
Men were more likely to get their quality of life back if they had a type of surgery that leaves the nerves controlling erection intact, for instance, and if they participated in a rehabilitation program.
While the study doesn’t prove that rehab is helpful — men who did better might be likely to join such a program, for example — the possibility is worth noting, said Dr. Mark Litwin, a urologist at the University of California, Los Angeles, who was not involved in the study.
Rehab programs, which are relatively new in prostate cancer care, can include talk therapy or a drug regimen to treat erectile dysfunction.
“It’s not just about recovery of the penis and its ability to become erect, but helping men come to terms with being a cancer survivor,” Litwin told Reuters Health.
Both physical well-being, such as experiencing less pain, and mental health, including feeling good and functioning well socially, were tied to remaining continent and not encountering any complications after surgery.
“Some of these things, no one can control, such as baseline PSA,” Litwin said. “But some they can. Patients can doctor-shop and find the best care.”
In the type of surgery the patients had, surgeons make a cut between the belly button and the pubic bone to get to the prostate, which is then removed entirely — so-called radical prostatectomy.
About one in six American men get prostate cancer at some point in their life, according to the American Cancer Society. But they don’t necessarily have to have their prostate removed because of it.
Some may get radiation treatment instead, or they may have their tumor destroyed by a kind of surgery that uses freezing liquids. Others may choose just to be monitored — so-called watchful waiting — to see if the cancer grows slowly enough to be safely ignored.
All of these strategies have problems of their own, and the right option depends on both the cancer and the patient’s values.
Litwin said most studies have focused on the drawbacks to prostate cancer surgery, and indeed, the new findings confirm that most men have worse sexual function after the procedure.
“Quality of life definitely takes a hit, both physically and emotionally,” Litwin added, “but ultimately, it tends to go back to normal.”
Dr. Merlin, of RC Cancer Centers, discusses prostate cancer and answers many common questions relating to the topic.
For those looking for a meaningful commitment on Valentine’s Day, RC Cancer Centers along with the Georgia Prostate Cancer Coalition, Atlanta Hawks, KISS 104.1, Atlanta Thrashers, WSB Radio, UPS, C.R. Bard, WXIA Television and Morehouse School of Medicine have issued a challenge to have 10,000 men in Georgia pledge to engage in a conversation with their doctors and/or get screened for prostate cancer between now and April 30, 2011.
Prostate cancer is one of the most common non-skin cancers in America. It affects 1 in 6 men and accounts for 28 percent of all new cancer cases among Georgia males each year. Getting a loved one tested may be the greatest gift of all this Valentine’s Day.
“Early detection is the greatest preventative measure a person can take,” says Dr. Mark Merlin radiation oncologist at RC Cancer Centers. More than 2 million men in the U.S. have been diagnosed with prostate cancer at some point and are still alive today, according to the American Cancer Society.
“It is crucial for men to maintain an ongoing relationship with their healthcare provider as the risk for prostate cancer will vary from person to person,” says Dr. Philip Shrake, radiation oncologist at RC Cancer Centers.
Show romance and affection a little differently this year and encourage the one you love to get a prostate cancer screening and start the dialogue with their doctor this Valentine’s Day.
RC Cancer Centers has partnered with the Atlanta Hawks and Atlanta Thrashers, UPS, CR Bard, WXIA Television, Morehouse School of Medicine, KISS 104.1 Radio and WSB Radio to support the Georgia Prostate Cancer Coalition in an effort to better educate men about their health choices and raise awareness about prostate cancer in the state of Georgia.
The prostate specific antigen (PSA) screening is a simple blood test that RC Cancer Centers is encouraging you to do for your love. Do it for each other.
To take the pledge or learn more about the Georgia Pledge Campaign, visit www.GeorgiaProstateCancerPledge.com.
A new study finds finger length may indicate a lower risk of developing prostate cancer. CNN’s Elizabeth Cohen reports.
Talking about prostate cancer and sharing information may be the most important thing you ever do for your friends and family in the new year.
Okay, I wasn’t planning to write a post this week. I was honestly going to give all of us a moment to enjoy the gentle quiet of the holiday week and a respite from thinking about cancer. However, a rather good article on prostate cancer and PSA testing was published this morning in the January 2011 Costco Connections. It changed my mind. The article, Men vs. Prostate Cancer, Why Your Best Shot at Beating it Is Early Detection, provides an easy-to-digest introduction to the disease and a clear discussion of how the PSA blood test is used for early detection.
Two concise pages provide an excellent opportunity to broach the subject with those men you care about. I then got to thinking that the article’s timing was perfect for the new year. Those of use who are close to prostate cancer can make an important resolution to raise awareness by sharing the article. And, those who are reading about it for the first time can make a resolution to talk to their physicians about early detection. Two birds, one stone. It’s an easy and healthy resolution for all concerned.
That’s all for now. Wishing you all a wonderful and health-filled New Year!
As the holiday season is upon us, WAPC has created a holiday ornament that we are selling as a fundraiser for our 2011 efforts. This small token can speak volumes as a gift for the supportive woman in your life, to show a prostate cancer patient that you care, or just to show your support of prostate cancer awareness. Families are fortunate that women can, and do, play an essential role in the prevention, early detection,research, advocacy, support, and caregiving for the prostate cancer patients they love. Show them that you recognize their encouragement and support by giving them a special ornament. See pictures and purchase online at: http://www.womenagainstprostatecancer.org/donate/holidayornament/
All proceeds will support WAPC’s 2011 efforts to make a difference in the lives of families effected by prostate cancer.
©2013 Physician Oncology Services. All Rights Reserved.
Also known as RC Cancer Centers.