September is prostate cancer awareness month, which means this is a perfect time to put prostate health in the spotlight. Increased awareness of the disease has encouraged more men to understand their risk, talk with their doctors and, when appropriate, get screened. The result? Earlier detection of prostate cancer and advances in treatment have helped cut the prostate cancer death rate by more than half since its peak in 1993.*
But as awareness grows and more testing procedures are available, many people are confused about who should get tested when, what the tests mean, and depending on the results, if further tests and more procedures are needed.
A complicating factor is that not all prostate cancers are the same. Some grow quickly, but others grow so slowly that they never cause a problem. While treating all prostate cancers early might seem to make sense, some grow so slowly that the tests and procedures to control the cancer might not be worth the risk in terms of potential side effects.**
One more thing: Finding prostate cancer isn’t always an exact science. Many prostate tests provide clues rather than clear answers. An abnormal exam, blood test, or even an MRI don’t necessarily mean you have prostate cancer, they only mean that your doctor will want to take a closer look. And there’s a risk of false positive test results, which happens more often in older men, and can cause undue alarm and even more testing procedures.***
So, what’s a man supposed to do?
The good news is that the path forward is easier than it sounds. The most important thing to do is talk to your healthcare provider about your personal situation. The fear of unnecessary tests should never stop you from having that important, initial conversation because in the right situations, testing and precautions save lives.
Let’s start with basic guidelines
In 2009, the American Cancer Society (ACS) Prostate Cancer Advisory Committee advised that the men described below should start initial conversations with their doctors about prostate screening:
- Men who are 55-69 years old at average risk should discuss if testing is warranted. Many men in this category may opt not to get tested.
- Men who are 40 years old and have a close relative who developed prostate cancer should also discuss testing. Studies show that men with a family history of prostate cancer are 2-3 times more likely to get the disease than men without the disease in their families.
- African American men will want to discuss when testing is right for them. Studies show that African American men are more likely to get prostate cancer compared to other racial backgrounds.
- Men who are showing suspicious symptoms need to see their healthcare provider right away. While early stages of prostate cancer rarely cause symptoms, it’s time to talk to the doctor if you experience problems such as a weak urine stream, a need to urinate often, an intense need to urinate, the inability to urinate, pain or burning when you urinate, and erections that are less than firm.
What does testing involve?
When you schedule a healthcare check-up, your doctor will likely take blood tests, and may also do a digital rectal exam (DRE) which enables the doctor to feel for any masses or hard areas on your prostate.
If blood tests show high levels of prostate-specific antigen (PSA), doctors might suspect prostate cancer. PSA is a specific protein made by the prostate, and higher-than-normal levels can sometimes be a sign of prostate cancer. But not always! High levels can also be caused by other prostate conditions. And even if a DRE reveals a suspicious mass, that doesn’t necessarily mean cancer, either.
If your PSA levels are high, a suspicious lump is found and/or there is blood that shows up in a urine test, your doctor may order a prostate MRI (magnetic resonance imaging) which can reveal suspicious masses, and tell your doctor whether or not to continue with a biopsy.
A biopsy always sounds scary, but there are critical benefits to having a biopsy if your doctor feels it’s necessary. The downside of a biopsy is that there is a degree of discomfort that follows the procedure, along with a low risk of infection or bleeding. The upside however, is that a biopsy is the only way to definitively determine whether you have prostate cancer and, if you do, how aggressive it is.
If the biopsy comes out positive, remember that early prevention saves lives, and a positive diagnosis does not mean a poor prognosis. There are different types of prostate cancer and different forms of treatment that can address the varying stages and types of the disease.
Questions to ask your doctor
The best way to protect yourself is to become your own advocate. And that means asking the right questions of your healthcare team. Sometimes, when we go to the doctor, it’s also helpful to make a list of questions to ask. Especially when and if you’re concerned about cancer. Here are some helpful topics you might want to discuss with your doctor:
- Based on my age and overall health, should I be screened for prostate cancer?
- What are the benefits and downsides of screening?
- Do I have any personal or family risk factors that make screening important for me?
- What is a PSA test, and what levels are considered suspicious?
- What can cause my PSA level to rise besides prostate cancer?
- If my PSA levels are high, what are the next steps?
- What are the different types and stages of prostate cancer, and what do they mean?
- If prostate cancer is found, does it always need to be treated right away?
- Could active surveillance (carefully monitoring the cancer) be an option for me?
- If I have prostate cancer, will I need surgery?
- What are the side effects of prostate surgery?
- What other treatments are available besides surgery?
- If I need treatment, could it affect my sex life or my ability to have an erection?
- Could additional screening or treatment affect my bladder control or urination?
- Could prostate cancer treatment affect my ability to have children?
Prostate Cancer Awareness Month isn’t just for those who suffer from prostate cancer. It’s also for the families, friends, and co-workers who love and care for the men in our lives. If you’re like many of us, you or someone you know has been touched by prostate cancer. For more information on testing, or to have a conversation on what next steps are best for you, call our office today for more information or to make an appointment. Visit us at https://www.premiermedicalhv.com/ or reach us at 845-565-4400.
**https://www.cancer.org/cancer/types/prostate-cancer/detection-diagnosis-staging/detection.html
***https://www.cdc.gov/prostate-cancer/screening/get-screened.html