Prostate Cancer and Screening: What You Need to Know
August 08, 2018
Submitted by Wes Baas, M.D., Urology resident at SIU Healthcare Urology Division and Tia Rapps, BSN, RN, CURN Urology Nurse Navigator of Memorial Medical Center
September is Prostate Cancer Awareness month!
The prostate gland is part of the male reproductive system that produces fluid to carry semen out of the body during ejaculation. It is normally a walnut-sized gland that sits just below the bladder and in front of the rectum. Prostate cancer is when malignant cells begin growing in the prostate gland. For early stage prostate cancer, there are typically no symptoms to warn that anything is wrong. It is one of the most common forms of cancer in men, second only to skin cancer. According to the National Cancer Institute, approximately 1.2 percent of men will be diagnosed with prostate cancer at some point during their lifetime. The good news is that the 10-year survival rate is nearly 98 percent when caught early.
Men between the ages 55 to 69, and some men as early as 40, if they are at high risk for cancer, are encouraged to think about getting screened for prostate cancer. Discussing risks and benefits of any cancer screening with your primary doctor is always a good idea. High-risk men include African-Americans and any man with a family history of prostate cancer.
Prostate cancer screening involves two parts. The first part is a blood test checking the level of Prostate Specific Antigen (PSA). This is a protein normally produced by the cells of the prostate gland. An elevated PSA can indicate something abnormal with the prostate. Elevated PSA does not necessarily mean that there is cancer present. Things that can elevate the PSA include recent sexual activity, an infection of the prostate, or simply having a large prostate. Further testing will help doctors determine if you have cancer or not.
The second part of the screening is the “DRE,” or digital rectal exam. This involves a physician inserting a lubricated, gloved finger into the rectum and pressing down to feel for any abnormal lumps or nodules on the prostate. Many men put off getting a prostate screening due to fear of the rectal exam. Despite how it may sound, the exam is usually very tolerable. Many men state that the exam was not nearly as bad as they had imagined it to be beforehand.
The most complete way to screen for prostate cancer is to get both the PSA and DRE. If something is abnormal, more testing and counseling by a urologist is recommended. Catching any cancer at an early stage gives the most treatment options to a patient and allows time for shared decision making. This means discussing the diagnosis, treatment options, side effects, and long-term outcomes with your personal doctor or urologist. After this discussion, you will be better armed with information to make the right decision for you and your health.
If you are diagnosed with prostate cancer, there are a number of possible treatment options. Options include active surveillance, surgery, radiation, or anti-hormonal therapy. Active surveillance remains an option for men who do not wish to immediately pursue treatment. Active surveillance entails monitoring the patient’s PSA and repeating a biopsy at least yearly to ensure that the cancer is not progressing. If progression does occur or if the patient changes his mind about observation, they can then move onto treatment.
One of the mainstays of prostate cancer treatment is surgery. While this used to entail having a large, open surgery, most surgeries are now done in a minimally invasive fashion. Minimally invasive radical prostatectomies are now done “robotically.” Robotic surgery involves having four to five small (smaller than one inch) incisions across the abdomen. Through those small incisions, the surgeon controls the instruments from a console and performs the surgery. The robot allows the surgeon to see in 3D with magnified vision and to make precise movements to help carefully remove the prostate. Minimally invasive surgery allows for smaller incisions and faster recovery times for the patient.
The next treatment option for prostate cancer is radiation therapy. There are two modalities currently used. The traditional “external beam” radiotherapy usually consists of presenting for radiation therapy five days a week for four to eight weeks, as determined by the radiation oncologist. Alternatively, the patient can undergo what is called “brachytherapy.” Brachytherapy consists of a short procedure in which radioactive “seeds” are implanted into the prostate. These stay in the prostate indefinitely. The “seeds” slowly secrete radiation locally in the prostate to destroy the cancer cells. This provides an option of one trip to the hospital for treatment versus multiple trips for daily treatments. Again, discussing what is best for you with your doctor is recommended.
Lastly, some men choose anti-hormonal therapy for management of prostate cancer. One way to think of prostate cancer is that it is “fueled” by testosterone, a hormone normally produced by the male testicle. Androgen deprivation therapy employs medications (either given by injection or orally) that stop the production of testosterone. This cuts off the “fuel” to the prostate cancer cells and suppresses their growth. This is usually reserved for men who have had the cancer spread outside of the prostate gland.
Prostate cancer is a relatively common cancer and is a treatable disease when found early. As such, prostate cancer screening is important for the health of all men over the age of 55, or younger for those at higher risk. You are encouraged to discuss risks and benefits of prostate cancer screening with your doctor. Whether you are contemplating screening or have been diagnosed, it is always important to find a good medical team with which you communicate well and that has your best interest at heart. A good way to actively participate in your healthcare is by being proactive; eating a healthy diet, exercising, eliminating smoking, and seeing your doctor regularly.
September is Prostate Cancer Awareness month!
If you are a male between the ages of 55 to 69, or as young at 40 with high risk, please join the Regional Cancer Partnership of Illinois on September 12th from 5 to 7pm, for a free prostate screening event!
This event will be held at the Sangamon County Department of Public Health located at 2833 South Grand Ave. East in Springfield, Illinois.
Call 217-535-3100, ext. 3744 beginning August 27th to preregister for an appointment time.
There will also be a short 30-minute presentation given by Dr. Sohail Siddique of SIU Department of Obstetrics and Gynecology
on women’s urinary incontinence. RCP hopes that women will encourage their male partner or friends to attend the screening.
While waiting on their partners, we encourage women to attend this free presentation at either 5:30pm or 6:15pm,
depending on their partner’s appointment time.
Back to Top