September is Prostate Cancer Awareness Month and an important reminder that the disease claims the lives of more than 30,000 men in the U.S. annually.
One in four deaths in the U.S. is due to cancer and prostate cancer is the second leading cause of death in the U.S., exceeded only by heart disease. What’s more is that 1 in every 9 men will be diagnosed with prostate cancer during his life. In fact, in 2016 in Washington, 4,157 cases of prostate cancer were reported.
The good news is that prostate cancer tends to grow slowly, and it can often be found while still contained to the prostate. This means in many cases, prostate cancer can be successfully treated if it is found before it has spread to other parts of the body. It also means that not every case of prostate cancer needs to be treated.
Following are some frequently asked questions about prostate cancer.
What are the risk factors for prostate cancer?
The main risk factor is age. There are clearly some genetic or inherited risk factors, but most of the time they are sporadic. Race can indicate more and less serious cancers; African American men tend to have more serious prostate cancers than Asian men do, for example.
Does prostate cancer always need to be treated?
NO! In fact, this is why I am passionate about the technology called Artemis MRI Fusion Biopsy. This system uses MRI findings and a robot-assisted biopsy platform to take very accurate samples. The idea is that we find the cancers that definitely need treatment more quickly. In addition, we can feel more confident about men with low risk cancer going on a surveillance plan that prioritizes regular testing over treatment.
If treatment is needed, what forms of treatment are used?
Surgical removal and radiation therapy are the most common treatments for prostate cancer. I also offer something called cryotherapy–treating the cancer in an outpatient setting using needles and extremely low temperatures to destroy the cancer.
What are common side effects of treatment for prostate cancer?
Depending on the type of treatment, sexual and urinary functions may be impacted. Occasionally some rectal/ bowel functions can be affected. The exact issues, degree of side effects, and duration are very individual and should be discussed carefully with the treating physician.
What can people do to lower the risk of getting prostate cancer?
The only known way to reduce the risk of prostate cancer are two related medications called finasteride and dutasteride. Commonly prescribed for enlarged prostate, a couple of very large trials have demonstrated their ability to reduce the chance of being diagnosed with prostate cancer.
What are the factors to consider when deciding whether to be screened for prostate cancer?
It is a risk and benefit discussion with one’s primary care doctor. I think some people should definitely have a lower threshold for screening: Men with a family history of cancer (yes cancer, not just prostate cancer, because we now know that the same genes can predispose you to numerous cancers like prostate, breast, ovarian and pancreatic. African American men should be screened, and men in their 40’s and older with urinary symptoms should get a PSA and a digital rectal (physical) exam.
What are the tests used to screen for prostate cancer and how accurate are they?
We are in a new era of prostate cancer screening, detection, and diagnosis. No longer is a routine PSA the only way we find prostate cancer. We have access to new tests of the blood and urine like Select MDX, and the 4K score to aid in screening. In my practice, I use imaging regularly. MRI’s of the prostate have proven to be quite helpful in determining which men may be at more or less risk for harboring prostate cancer. So, the old adage that the PSA test is not helpful is simply not true. When discussing with a urologist with a special interest in prostate cancer diagnosis, like myself, there are usually several tests that are incorporated into the decision making of whether to take further steps such as prostate biopsy (for example the Artemis MRI guided Biopsy).