The American Cancer Society estimates 299,000 men will be diagnosed with prostate cancer this year, with 35,000 dying from the disease. What can one do to minimize their risk of perishing from this treatable form of cancer?
Brian Keith McNeil, M.D., M.B.A., FACS
Associate Dean for Clinical Affairs; Vice-Chair, Department of Urology, SUNY Downstate Health Sciences University
The summer before my senior year of high school was filled with fun moments with friends, long days on playground basketball courts, and hope that my father would live long enough to see me graduate from high school. A diagnosis of metastatic prostate cancer tempered his gregarious spirit, limiting his ability to work. He soon died, at the beginning of my senior year.
We have learned a great deal about prostate cancer since then. I became a urologist, hoping to spare other families the grief that comes with losing a loved one to cancer way too soon. Let’s break down some of the stigmas surrounding prostate cancer screening, diagnosis, and treatment.
Diagnosing prostate cancer
Men with prostate cancer often have no obvious signs or symptoms of the disease. Even though one may feel well, it is important to have periodic conversations with your healthcare provider about prostate cancer and whether or not you should get screened for it. Urologists often refer to this process as shared decision-making. Shared decision-making is a collaborative process where you work with members of your healthcare team to make the best decisions regarding your health. You should have a conversation about prostate cancer screening if you are between the ages of 45 and 50.
There are a few known risk factors for developing prostate cancer. They include increasing age, a family history of prostate cancer, African ancestry, and certain genetic mutations. If you fall into any of these categories, you should initiate a conversation about screening even sooner, sometime between the ages of 40 and 45.
One thing that hinders some from getting screened is the presumed need to undergo a digital rectal examination (DRE) in addition to a blood test for Prostate Specific Antigen (PSA). DRE and PSA are not perfect tests, and there are some men with “normal” findings who harbor prostate cancer. However, they serve as guides to help us determine who should undergo further testing for prostate cancer. Some reports have suggested that having your blood drawn for a PSA test alone, without a DRE, may be enough to detect aggressive cancer in most men. Even if one feels uncomfortable with having a DRE, please consider having a PSA test done to determine if further tests are needed to assess your risk of prostate cancer. There are a number of tools at your disposal to help you make the best decision regarding your health.
Prostate cancer is diagnosed with a biopsy. Having an elevated PSA level that falls outside of the normal range does not necessarily mean that one has prostate cancer. There are other things that may cause a rise in one’s PSA level, making biopsy a necessity to make a diagnosis.
Maintaining hope
Being diagnosed with prostate cancer is not a death sentence. There are several treatment options for prostate cancer depending on the grade and stage of the tumor. Every person diagnosed with prostate cancer is assigned to a risk category (low, intermediate, or high). Treatment options vary depending on your risk category. Early diagnosis and treatment afford one the best chances of conquering this disease.
Prostate cancer remains the most commonly diagnosed cancer in men and the second leading cause of death. Even with advances in the screening, diagnosis, and treatment of this disease, countless men around the world continue to die from prostate cancer that don’t have to. Please have a discussion about prostate cancer screening with your healthcare provider. Just think about your loved ones, who would miss you if you were no longer here.
