By THOMAS R. CLEMENTS, M.D
So, what does a woman need to know about prostate cancer?
Last I checked, women don’t have prostates; however, most woman have a man in their lives, whether that be a husband, father, grandfather, son, or friend who does have a prostate.
Let’s face it: Men don’t have the greatest track record when it comes to keeping tabs on their own health. So every woman should know something about prostate cancer to keep the men in their lives on the right track.
The prostate is a part of the man’s reproductive system. Its primary function is to make part of the seminal fluid that carries the sperm out of the body. It is located deep in the pelvis, underneath the bladder and in front of the rectum.
A normal prostate is about the size of a walnut. As the prostate grows, it can squeeze the urethra, the tube in which urine flows, and cause difficulties with urination.
Prostate cancer begins at the cell level. Normal cells in the prostate and other parts of the body grow and divide from new cells as they are needed. Sometimes, however, this process goes wrong.
New cells form when the body doesn’t need them, and old or damaged cells don’t die as they should. The buildup of extra cells often forms a mass of tissue called a growth or tumor.
What’s so important about prostate cancer, you ask? Well, after skin cancer, prostate cancer is the most common cancer in American men.
Yes, that’s right; it’s the second most common cancer in men! In 2015 alone, it is estimated that there will be 220,800 new cases of prostate cancer. In addition, there will be 27,540 deaths from prostate cancer.
How does that rank in overall deaths from cancer? It’s in second place, only behind lung cancer. Prostate cancer can be a serious disease.
Fortunately, most men diagnosed with prostate cancer will not die from it. About 60 percent of the cases are diagnosed in men over the age of 65. Some of the risk factors for prostate cancer include: race, family history, diet, age, smoking, and obesity.
Screening for prostate cancer is the best way to stay protected (and be informed). In general, screening is recommended for all men between the ages of 55 and 69 years old.
Getting checked for prostate cancer involves three simple steps: a visit to your doctor, a blood test, and a digital rectal exam. The visit with the doctor will include an analysis to one’s personal health history to look for any potential risk factors.
There is a blood test is for the PSA (prostate specific antigen). This is a protein that is secreted by the prostate into the blood stream and will be elevated in most cases of prostate cancer. In years past, we used to say that a PSA
over the level 4 was concerning. We now know that the PSA gradually increases as we get older, so there are new age-specific levels of normal.
In the last few years, there has been a lot of press about the PSA. To that I would say that it’s not a perfect test, but it’s simple, and over the last 20 years has significantly helped men get diagnosed with prostate cancer at earlier stages.
The rectal exam is also a critical test to screen for prostate cancer. If either the PSA or rectal exam findings are concerning, a biopsy would be recommended. This is performed with an ultrasound probe through the rectum followed by 12 small needle cores taken from the prostate. It is typically done under anesthesia.
After the biopsy is done, a pathologist will look at the tissue and decide whether or not cancer is present. If it is, they will give it a Gleason grade, which is a way to look at how aggressive the cancer is.
There are also several new genetic tests that help grade aggressiveness. Fortunately, there are many good treatment options for prostate cancer.
Some include: active surveillance (watchful waiting), surgery, radiation therapy, brachytherapy, hormone therapy,
cyrotherapy, and chemotherapy.
Each treatment has specific advantages and risks associated with it and will be discussed in great detail with your urologist once the diagnosis is made.
Prostate cancer is treatable and even curable when detected early. According to the most recent data, when including
all stages of prostate cancer, the five-, 10-, and 15-year survival rates are 100 percent, 99 percent, and 94 percent,
So, take time to ask the men in your lives about their prostates. Ask them about the last time they got checked. Have them tell you their latest PSA. Remind them that a simple blood test and a rectal exam is nothing compared to what you have to go through every time you see your gynecologist or have a mammogram.
Thomas R. Clements, M.D., is a urologist with Urology of Central PA in Harrisburg. He is board certified by the American Board of Urology.