Facts About Prostate Cancer
Author: Laura Gater

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Although prostate cancer is the number one cancer among men, it can be cured if caught early.

Early detection rates for this disease have improved substantially with a combination of two tests: a digital rectal examination and a blood test, otherwise known as a prostate-specific antigen (PSA) test. PSA is a protease that is secreted by cells in the prostate and used to diagnose prostate cancer since its concentration in the blood serum tends to be proportional to the clinical stage of the disease.

Early Detection is the Key

Males at high risk for the disease are those with a family history of prostate cancer as well as African-Americans.

“We recommend individuals at high risk and over age 40 have a yearly rectal exam and a PSA test,” says David Pollifrone, MD, Northeast Indiana Urology, Fort Wayne, IN.

If there is no family history of prostate cancer, males can wait until age 50 to have a yearly rectal exam and PSA test.

The “free PSA” test is a relatively new way to determine whether PSA elevations are likely to be cancerous. This test is another tool to help determine which patients need a biopsy and which do not. Prostate biopsies are conducted with ultrasound. The “free PSA” refers to a type of enzyme in the blood, rather than the cost of the test.

“The higher the amount of free PSA, the better off you are,” explains Dr. Pollifrone. “The lower the free PSA, the more likely that we will find cancer in your prostate.”

Some environmental factors may contribute to a higher risk, according to Dr. Pollifrone. One study he cited had followed Asian males who had consumed a low-fat diet in Asia, but within a generation of assimilation into American culture and eating American food, had the same levels of prostate cancer as other American males. Along with a low-fat diet, males should avoid smoking and Agent Orange, which has been recognized by the Veterans Administration (VA) as an environmental cause of prostate cancer.

Dr. Pollifrone explains that about 20 percent of all prostate cancer victims will have a normal PSA, but when the rectal exam and PSA are both done, they catch about 97 percent of all prostate cancer.

“There really aren’t symptoms until the disease has progressed far along,” explains Dr. Pollifrone. “Getting up at night to urinate and trouble starting the urine flow is evidence of benign prostate growth, not prostate cancer.”

In later stages of prostate cancer, men may have extreme trouble with urination, and suffer weight loss and bone pain.

“More men die with prostate cancer than from it,” notes Dr. Pollifrone. Roughly 70 percent of men in their 80s will develop prostate cancer.

As men age, their prostate gland enlarges. Benign prostate growth is a uniform or symmetric enlargement of the prostate. As the prostate gets bigger, it presses on the urethra and thus affects the flow of urine. Although benign prostate growth is a disease, it is a natural process of aging and very rarely causes life-threatening problems.

“In the early stages, prostate cancer is very curable. In the late stages, it may be curable,” says John Crawford, MD, radiation oncologist, Radiation Oncology Associates, PC, Fort Wayne, IN.

High-Tech Treatment Options

The localized cancer cure rate is at least 10 percent to 20 percent higher than it was 20 years ago, according to Dr. Crawford, meaning that if the cancer hasn’t spread and is confined only to the prostate, there is a higher cure rate today.

“If you do get prostate cancer, make sure you learn about all of the treatment choices available, and the advantages and disadvantages of each. Discuss surgical options and radiation options with your doctor,” states Dr. Crawford. “People have different reactions to their diagnosis [of prostate cancer]. They try to make an informed choice as to what treatment works best for their wishes.”

There are many different options for treatment, depending on the stage of cancer, the age of the patient, and the patient’s medical condition. Cancer is graded two to ten, two being less serious, with a ten being the worst.

“Is it our treatments that have improved survival rates or is it that we’re detecting cancer sooner?” asked Dr. Pollifrone. “It’s probably earlier detection. Prior to the development of the PSA test, 25 percent of the men who came in with prostate cancer already had it in their bones. After the PSA, only three percent of the men who came in with prostate cancer already had it in their bones.”

Prostate cancer treatments today are “quite revolutionary” today, compared to just five years ago, according to Dr. Crawford.

Despite the revolutionary options available, sometimes it is best to just observe the cancer. This may be a viable option in an older patient who has other, more urgent health problems. Another option is to have the prostate removed (a procedure known as a radical prostatectomy). External radiation therapy for seven to eight weeks is another option. Male hormone suppression, which chemically “turns off” the production of male hormones, is another choice for treatment. Radioactive seed implants in the prostate are one way to spare the tissues outside the prostate from being damaged from radiation treatments.

Cryosurgery is a newer treatment technique that freezes the prostate tissues, prohibiting the growth and spread of the cancer. A laparoscopic prostatectomy is a method of removing the prostate gland without major incisions and minimizes pain and scarring. High density radiotherapy delivers a high dose of radiation over 24 to 48 hours. The patient is hospitalized for this treatment.

“The radiation options are much more sophisticated than they used to be. With advances in imaging, we can pinpoint the cancer and focus on it. The absolute newest option is Intensity Modulated Radiation Therapy, or IMRT. With it, we can make the radiation therapy very tight around the prostate only. The rectum, bladder and other tissue surrounding the prostate are less affected with IMRT.”

Improved treatment is also helping to arrest the spread of this disease among men.

© Copyright, peoplemenders, 2009. All Rights Reserved.

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About the Author
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Laura's writing specialties are medical, health and business topics.

Just a few of her published writings: Medical Imaging, 24x7, Podiatry Management, Strategic Healthcare Marketing, Advance for Imaging & Radiation Therapy Professionals, Podiatry Management, RT (Respiratory Therapy),Corrections Forum, Radiologic Technology, For the Record, Plastic Surgery Products, Orthodontic Products, Chiropractic Products, Podiatric Products, and The American Journal of Managed Care (supplement on NSAIDs).

Laura is also the temporary medical producer for several websites, writing news briefs.  She has also done healthcare research and reports, provided public relations for several non-profit organizations and taught freelance writing classes.
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