Know the risk factors and symptoms of prostate cancer

Fellas! September is a good time to get the latest information about prostate health and disease, and the most effective treatments currently available for prostate cancer.  September is National Prostate Health Month, also known as National Prostate Cancer Awareness Month. Each year, more than 174,000 men are diagnosed with prostate cancer, and more than 31,000 die from the disease.  Most prostate cancer is diagnosed in men older than 65.  

Symptoms of prostate cancer include difficulty with urination and dull pain in the pelvic area, lower back, hips or upper thighs, but sometimes there are no symptoms at all.  Some types of prostate cancer grow slowly, and monitoring is recommended. Other types are aggressive and require a more intense treatment approach.  Addressing prostate health and disease begins with a conversation between you and your healthcare provider.  

Know your risk factors

All men are at risk for prostate cancer. Out of every 100 American men, about 13 will get prostate cancer during their lifetime, and about two to three men will die from prostate cancer. The most common risk factor is age. The older a man is, the greater the chance of getting prostate cancer. But other factors can increase a man's risk for the disease:

• Age: As men age, their risk of getting prostate cancer goes up. Harm to the DNA (or genetic material) of prostate cells is more likely for men over the age of 55.
• Ethnicity: African American men have a higher rate of the disease. One in six African American men will be diagnosed with prostate cancer. Prostate cancer occurs less often in Asian American and Hispanic/Latino men than in non-Hispanic white men.
• Family History: Men who have a grandfather, father or brother with prostate cancer face a higher risk of getting the disease. Having family members with breast or ovarian cancer also raises a man’s risk for prostate cancer.
• Weight: Studies have linked being overweight in your 50s and later to a greater risk of advanced prostate cancer. Doctors advise keeping to a healthy weight to reduce risk.

Get Screened

It is recommended to talk with your doctor about the benefits and harms of screening (testing) for prostate cancer.  If your primary provider believes that you are at elevated risk, or are showing symptoms of prostate cancer, they will start the process by ordering lab work. Two tests are commonly used to screen for prostate cancer:

1. The digital rectal exam, in which a provider inserts a gloved, lubricated finger into the rectum to estimate the size of the prostate and feel for lumps or other abnormalities. 
2. The prostate-specific antigen test, which measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer. The PSA level may also be elevated in other conditions that affect the prostate. As a rule, the higher the PSA level in the blood, the more likely a prostate problem is present. But many factors, such as age and race, can affect PSA levels. Some prostate glands make more PSA than others.  So your provider is the best person to interpret your PSA test results. Only a biopsy can diagnose prostate cancer for sure.

If the lab work comes back with PSA levels over 10, the patient will be referred to see a urologist.  A urologist is specially trained to treat problems affecting the urinary tract and disorders of the male reproductive system. Our trained specialist at UHS Urology will continue testing before determining next steps for treatment.

Treatment

If treatment is the next step, the Urology team with refer the patient to Medical Oncology. Our staff at UHS Medical Oncology is trained in a number of different therapies and treatments.

Today several types of treatment are available for prostate cancer. You and your provider will decide which treatment is right for you. Some common treatments are:

• Active surveillance. Closely monitoring the prostate cancer by performing prostate specific antigen (PSA) and digital rectal exam (DRE) tests regularly, and treating the cancer only if it grows or causes symptoms. 
• Surgery. A prostatectomy is an operation where doctors remove the prostate and surrounding tissue. 
• Radiation therapy. Using high-energy rays (similar to X-rays) to kill the cancer. 
• Other treatments, such as hormone therapy, cryotherapy, chemotherapy or biological therapy. 
• High-intensity focused ultrasound. This therapy directs high-energy sound waves (ultrasound) at the cancer to kill cancer cells. 

So have that conversation with your doctor. Together you can map out a plan for the approach to prostate health and disease that will meet your individual needs. 

For more information about prostate cancer and other men’s health issues, visit nyuhs.org.