Prostate Cancer – am I at risk?
Prostate cancer is the second most common cancer occurring in men. One in six men can expect to receive a diagnosis of Prostate cancer within their lifetime. However, with a cancer-specific five year survival rate approaching 100% death from prostate cancer is actually not common. Most men with Prostate cancer actually die from other causes such as heart disease or old age.
Prostate cancer has one of the strongest relationships between age and any human malignancy. Clinically diagnosed prostate cancer rarely occurs before the age of 40, but the incidence rises rapidly thereafter.
The risk of prostate cancer is increased approximately two-fold in men with one or more affected first-degree relatives (brother, father). Interestingly enough, the presence of BRCA1 or BRCA2 mutations increases the risk of developing prostate cancer.
Other risk factors for developing prostate cancer include chronic inflammation of the prostate called prostatitis or certain vitamin deficiencies like Vitamin D and E. Regular ejaculation has been shown to reduce the risk of developing prostate cancer.
Screening for prostate cancer should occur routinely in all men over the age of 50 in a similar manner to breast cancer screening in women. All men should undergo annual screening for prostate cancer.
Prostate Specific Antigen (PSA) is a protein that is measured on blood tests and can be used extremely effectively as a screening tool for prostate cancer. The protein is produced in the prostate and is elevated in a couple of conditions including prostate cancer.
An elevated PSA does not confirm the diagnosis of prostate cancer, but it will direct your doctor to perform some furthers tests including an ultrasound and biopsy of the prostate.
Another important screening test is the Digital Rectal Examination (DRE) which should be performed on all men every couple of years to feel for any abnormalities in the prostate. Although this is an uncomfortable test, it is extremely important in order to detect hard lumps.
The DRE and PSA test are often used in combination to be able to accurately detect prostate cancer in men.
Prostate cancer often causes no symptoms at first. But if symptoms do occur, they can include:
• Needing to urinate more often than usual
• A urine stream that is slower than usual
• Trouble getting an erection
• Blood in the urine or semen
When detected early enough, prostate cancer treatment has an exceptionally high success rate.
Men with prostate cancer often have a choice of treatment. Treatments options might include:
• “Watch and wait,” called active surveillance — men who choose this option do not have treatment right away. But they do have routine tests to check whether the cancer starts to grow more quickly. If so, they can start active treatment.
• Surgery — Prostate cancer can sometimes be treated with surgery to remove the prostate gland.
• Radiation therapy — Radiation kills cancer cells. Radiation can be given externally from a machine. Or a doctor might put a source of radiation directly into the prostate gland called brachytherapy.
• Hormone therapy — Male hormones in the body make prostate cancer grow. Hormone therapy reduces the levels of these hormones, which can shrink the cancer. For hormone therapy, men might take medicines. Or they might have surgery to remove the testicles. (Male hormones are manufactured in the testicles.) This treatment is usually only for men with advanced cancer. But some men with early stage prostate cancer get hormone therapy along with radiation or surgery.
The most important thing is to discuss with your doctor what screening schedule is correct for you and to take responsibility for your own prostate cancer screening.
Written by Dr Owen Nosworthy