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Early Detection is Key: Screening & Treatment for Prostate Cancer

Prevalence High; Second Leading Cause of Cancer Deaths Among Men

Among men prostate cancer is the most common cancer and the second leading cause of cancer deaths next to lung cancer. The risk of developing prostate cancer increases dramatically after the age of 40. You face an increased chance if a brother or father has had it.

Screening and Detection
Physical Exam
Early detection is the key to beating prostate cancer. Yearly checkups for men over 40 should include a digital rectal exam (DRE)—in which the physician feels the size and shape of the prostate through the rectum wall. This test helps detect prostate cancer at an early, curable stage.

Blood Test
Annual screening with a prostate specific antigen (PSA) should begin at age 50 unless there is a strong family history of prostate cancer, in which case these exams should begin at age 40. This simple blood test measures an enzyme produced exclusively by the prostate that rises abnormally with the presence and progression of prostate cancer. (Some increase occurs naturally with age.) PSA combined with DRE is the best strategy for catching curable tumors.

Ultrasound
Other testing includes using transrectal ultrasound, in which sound waves create a picture of the prostate, charting PSA velocity, and measuring PSA density.

Early Stages
In its early stages prostate cancer may not present symptoms. That’s why regular screening is so important. When they do occur, symptoms are often associated with benign prostate hyper-plasia (BPH), a noncancerous growth that causes prostate enlargement. One of the signs of both is the urge to urinate more frequently. And the only way to distinguish between BPH and prostate cancer is to have a medical exam.

Symptoms
As the disease progresses, symptoms include painful or difficult urination, blood or pus in the urine or semen, and painful ejaculation. With the spread from the prostate to nearby lymph nodes, bones or other organs, many men experience aches and pains in their joints or bones, especially the back and hips.

Treatment Options

Watchful Waiting
Watchful waiting involves careful observation without immediate treatment for prostate cancer. This may be an appropriate therapeutic course for men who:
• Are found to have slow-growing tumors
• Are older than 70
• Have significant coexisting illnesses
• Are fearful of the side effects of more aggressive therapies

Medication
The goal of medical therapy for prostate cancer is to shut down the production of the male hormone testosterone. The reason for this is that testosterone, which is produced almost entirely by the testicles, can stimulate the growth of hormone-dependent prostate cancer cells the same way kerosene fuels a fire. There are various types of hormonal therapy.

Radiation
Radiation therapy involves exposing cancer cells to high doses of radiation in the hope of killing the tumor. The most widely used types are external beam radiation therapy and internal radiation therapy (seeds).

Surgery
The goal of surgery is to remove the entire prostate gland and all of the cancer. A number of techniques are used by surgeons when operating on the prostate.

A relatively new treatment option is da Vinci Prostatectomy, a minimally invasive surgery assisted by robotic technology that gives the surgeon greater visibility, dexerity and precision. Additional benefits of the surgery include less pain, less risk of infection and faster recovery over traditional surgery. The da Vinci® Surgical System is also used in cardiac and gynecological surgeries.

Different treatments carry various risks and the chance of side effects. Your doctor will discuss all of your options and which treatments are best for you.

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