- - Friday, September 16, 2016

Prostate cancer is one of the most common types of cancer among American men and the risk goes up as men age. And, too, it is the second leading cancer killer of men (after lung cancer) – but it can often be treated successfully. Today, more than 2 million men call themselves prostrate cancer survivors, and while preventing prostate cancer may not be possible at this time, early detection does save lives.

Yet, there is controversy about screening — if you should get screened at all, when, and how often. And if you are diagnosed with prostate cancer, there is controversy if you should frequently monitor the cancer, rather than actual treatment, and watchfully wait, known as active surveillance. This may raise eyebrows… how do you not remove cancer?

I would like to underscore that while experts continue to debate guidelines and recommendations, every man should be familiar with prostate cancer symptoms and talk with their doctor if and when screening should be started and how frequently.

Dr. Nina’s What You Need To Know About Prostate Cancer

What is the prostate?

A small gland in approximate size and shape to a walnut the prostate is part of the male reproductive system. The prostate surrounds the urethra, which is the tube that carries urine from the bladder.

What is prostate cancer?

Cancer (abnormal, uncontrolled growth) that forms in tissues of the prostate. Because the prostate surrounds the urethra, a tumor can impede and eventually completely block urine flow.

And, if these cancer cells break away, they can travel through blood and lymph vessels to other parts of the body, and even attach to other tissues and grow to form new tumors that may damage those tissues. This is called metastasis. The most likely site of prostate cancer metastasis is the bone, followed by lung and then the liver.

What are risk factors for prostate cancer?

Age. According to the American Cancer Society, the rate rises rapidly after age 50 and 6 in 10 cases of prostate cancer are found in men older than 65 years of age.

Race. For reasons that are not known it is more prevalent in African American men. Additionally, mortality (dying) from prostate cancer is twice as likely.

Family history. Having a father or brother with prostate cancer more than doubles a man’s risk of developing prostate cancer.

Weight. Researchers from Harvard found a man’s risk for prostate cancer jumps 15 percent for every 5-unit rise in his body mass index (BMI).

What are symptoms of prostate cancer?

Generally, early stages of prostate cancer have no symptoms. As the cancer grows or spreads, men may experience

* A slow or weak urinary stream

* The need to urinate frequently

* Blood in their urine

* Erectile dysfunction

* Pain in their back, hip or ribs, and even weakness or numbness in the legs or feet from metastasis

It should be noted that these symptoms are not specific to prostate cancer, meaning that the cause can be from other conditions. However, if you are experiencing any of these, you should speak with your healthcare provider to help get to the bottom of things.

How do we screen for prostate cancer?

Screening refers to finding cancer before someone has symptoms, in the earliest of stages, which improves treatment options and outcomes. At this time, the standard screening exams include PSA (prostate specific antigen) levels and a digital rectal exam.

PSA is a protein produced by prostate gland cells and can be measured by a blood test. Levels may be elevated with prostate cancer as well as benign prostatic hyperplasia (enlarged prostate), prostatitis (inflamed prostate), urinary tract infection, and, even, with no abnormality.

A digital rectal exam allows the healthcare provider to palpate (feel) for size and other abnormal growths (e.g., hard areas or lumps) that may suggest prostate cancer.

When should I start getting screened for prostate cancer?

Over the last several years, there has been much discussion and controversy regarding screening guidelines — with different organizations making different recommendations on the age to begin screening and how frequent. What is agreed upon is that men should be aware of the potential harms and benefits before getting tested.

You should discuss screening with your health care provider at age 50 (along with routine screening colonoscopy). And, if you are at an increased risk for prostate cancer — brother or father with prostate cancer, African American — screening may be considered at age 40 or 45.

What is the controversy over prostate cancer screening?

PSA levels are not specific to prostate cancer, which can lead to “false-positive” results and a litany of additional testing that carries their own risks, along with unnecessary worry.

Consequently, some organizations have warned against it. The trusted U.S. Preventive Services Task Force concluded “that the expected harms of PSA screening are greater than the potential benefit.”

On the other hand, prostate cancer takes nearly 30,000 American lives a year and elevated PSA levels may be the only indication that you have prostate cancer before it is widespread and too late. Again, the decision to get screened should be made after careful research and a discussion with your healthcare provider, to determine if it is right for you.

What are treatment options for prostate cancer?

Because the vast majority of prostate cancers are slow-growing, do not spread, small, and asymptomatic — they do not kill. Additionally, studies have shown that for these types of tumors, treatment does not increase life expectancy. And, too, treatment can lead to complications, including bowel and bladder incontinence, erectile dysfunction, and even death.

As a result, over the last several years, a growing number of men (approximately 50 percent) have chosen active surveillance: careful monitoring of the cancer with PSA and digital rectal exams and prostate biopsies. If there is a change in your test results, then treatment can be discussed.

Treatment options vary depending on your stage of cancer, symptoms, and, too, general health. They include surgery, radiation, hormone therapy, chemotherapy, cryosurgery (the use of extremely cold temperatures to freeze the cancerous cells), vaccine treatment (known as immunotherapy, that uses your immune system to attack the cancer), and angiogenic therapy (preventing growth of new blood vessels that feed the cancer).

How Can I Prevent Prostate Cancer?

At this time there is no evidence that prostate cancer can be prevented. However, experts recommend maintaining a healthy weight; staying physically active; and eating a balanced diet filled with vitamins, nutrients and antioxidants. When it comes to what we consume, there is research that  suggests cutting back on red and processed meats. limiting high fat foods, and eating a diet rich in fruit and veggies may be effective.

Men, and the ladies who love them, it is important to discuss prostate cancer screening with your physician and know the symptoms. Statistics show that on average, men live 5 years less than women – and too, that culturally women surpass men in asking for help with their health. Research further shows that many men only seek medical counsel when under duress from a spouse or when their condition has deteriorated to a severe state. Take action and talk with your doctor, who can help you determine whether the test is the right option for you.

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