Prostate Cancer
Prostate cancer is one of the most common types of cancers in men. About 1 in 8 men get prostate cancer in the United States, but only about 1 in 40 men die because of prostate cancer. It is the number 2 cancer leading to death in men (behind lung cancer), but it also one of the more treatable cancers if it is caught early.
It is primarily screened for yearly with a PSA blood test starting at the age of 50. If you are African American or have a family member who has prostate cancer, we recommend starting screening by age 35. Please refer to the “Elevated PSA” link below for more details on that.
Symptoms:
Generally, there are no symptoms to early prostate cancer other than an elevated PSA blood test. Therefore it is extremely important to get a PSA yearly.
As prostate cancer grows and spreads there can be a multitude of symptoms including:
- Urinary issues- slow stream, urgency, frequency, etc
- Hematuria (blood in the urine)
- Hematospermia (blood in the sperm)
- Abdominal or pelvic pain
- Hip pain
- Rib pain (cancer can spread to any bone and cause pain or a fracture)
These symptoms are very generic and don’t mean you have prostate cancer. So please don’t jump to conclusions if you have these symptoms. Most people with these symptoms usually have a more reasonable and easier to treat problem, so discuss them with Dr. Shaba.
Risk Factors:
- Being a man- 1 in 8 men will get prostate cancer
- African American men have double the risk- so 1 in 4
- A family member with prostate cancer doubles the risk- so 1 in 4
- Anyone exposed to Agent Orange
Generally, diet or lifestyle does not factor into prostate cancer, but we always recommend a healthy diet and avoid smoking or chemicals.
Evaluation:
Prostate cancer is diagnosed by an elevated or rising PSA in over 95% of the cases. Your primary care doctor will order a PSA blood test yearly for you starting at age 50 for most people or age 35 for those at higher risk.
Sometimes an abnormal DRE (digital rectal exam) can find a nodule or hard spot which can be cancer.
Rarely, imaging can find a prostate cancer. Usually this would be an MRI of the prostate, however this is not the preferred or even the best way of finding prostate cancer. Talk with Dr. Shaba about what is the best way for your specific situation.
There are many genetic and other tests that have been developed or are continuing to be developed. Many of these tests just give you a percent chance you may have prostate cancer and cannot diagnose you. They also can be very expensive and not covered by your insurance.
Anyone with an elevated PSA or abnormal DRE should have a prostate biopsy to evaluated for prostate cancer. The biopsy is still the best and most accurate way of diagnosing prostate cancer.
Treatment:
There are many different options for treatment of prostate cancer. Dr. Shaba will go into detail about the pros and cons of each of these types of treatments if you are diagnosed with prostate cancer. Treatment can depend on your age, type/grade/stage of prostate cancer and your overall health.
Some of the most common treatments are:
- Surgery- to remove the prostate
- Radiation- external beam vs seeds.
- Active Surveillance- not treating, but monitoring the cancer with PSA levels and repeat biopsies
- Chemotherapy- for advanced disease
- Hormonal blockade- usually used for recurrent disease but also can be used in conjunction with other treatments
- HIFU- high intensity ultrasound
- Proton Beam- a type of radiation
- Cyberknife- another type of radiation
- Cryotherapy- freezing the prostate usually only used in rare circumstances
For more information please visit: https://www.urologyhealth.org/urologic-conditions/prostate-cancer
