A healthy prostate is important because it affects sexual and urinary functions. But many men tend to put off regular health checkups and screenings — particularly when it comes to the prostate.
The prostate gland is about the size of a walnut and sits just below the bladder and in front of the rectum. Its primary function is to produce the liquid that transports sperm.
Unfortunately, 1 in 8 men will develop prostate cancer — the second-leading cause of cancer-related death in men — in their lifetime. But as with most cancers, when prostate cancer is caught early, it’s easier to treat, and the chances for survival are good.
How Screening Saves Lives
Timely screening for prostate cancer is essential. A growing number of experts feel that prostate cancer is slow-growing. Many men who have it may never develop cancer or even know they have the disease until they’re screened.
Men at average risk should consider beginning screening for prostate cancer at age 50. During the screening appointment, a discussion of personal and family health history will take place, followed by a prostate-specific antigen (PSA) test and, possibly, a physical prostate exam.
Men should continue to be screened every one to two years, depending on their PSA level. The amount of PSA in a man’s system is a gauge for a certain protein that, when high, can be a sign of cancer.
For men who are at higher risk, including those with a family history of prostate cancer and African American males, initial screening is recommended at age 45.
Answers to 7 Common Questions
Along with information on screening, many of my patients want to know the following about prostate cancer:
- What are the symptoms of prostate cancer?
Symptoms of prostate cancer include weak urine flow, decreased sexual function, painful urination, frequent nighttime urination, and the presence of blood in the urine or semen. However, in some instances, there are no symptoms, which is why screening is essential. - What are the risk factors?
The most common risk factor is age. The older a man is, the greater the chance of getting prostate cancer. And according to the American Cancer Society, prostate cancer develops more often in African American men and Caribbean men of African ancestry than in men of other races. Further, men who have a family history of prostate cancer are at higher risk. - What is a PSA blood test?
A prostate-specific antigen blood test measures the level of a protein called prostate-specific antigen, made by cells in the prostate. The chance of having prostate cancer goes up as the PSA level goes up, but no set cutoff point can indicate with certainty whether a man does or doesn’t have prostate cancer. If a man’s PSA level is high, he might need further tests. - How is prostate cancer treated?
When a biopsy reveals cancer, a pathologist provides the patient with essential information, such as the cancer’s aggressiveness, extent of invasion, grade and other details that factor into treatment options. A few common treatment options include active surveillance, surgery and radiation therapy. For higher stage disease, treatment may also involve targeted and systemic therapies, including hormonal therapy, chemotherapy or immunotherapy. - What is active surveillance?
Because prostate cancer often grows very slowly, some men — particularly those who are older or have other serious health problems — don’t receive treatment and opt for active surveillance. This usually includes regular monitoring, follow-up doctor visits, and testing at regular intervals. - Are there any lifestyle changes, such as diet or exercise, that could help reduce risk?
Eating a balanced diet that includes plenty of fruits and vegetables, avoiding or limiting red and processed meats and fatty foods, and staying physically active to maintain a healthy weight can help decrease risk. - Are there any new advancements in the detection of prostate cancer?
Pathology analysis — the analysis of blood, urine and tissue samples to examine and diagnose disease — has changed and become more sophisticated. It’s now more than a pathologist looking at a biopsy. The specimen can be sent for analysis of genes — both inherited and acquired mutations in DNA — which is valuable when determining how aggressive the cancer may behave.
Prostate cancer screening can help detect signs of cancer before symptoms start. It’s essential for men to talk with their doctor about the pros and cons of screening and what’s right for them.
Dr. David Bodkin is a Sharp Community Medical Group board-certified hematologist/oncologist affiliated with Sharp Grossmont Hospital and Sharp Coronado Hospital.
