Prostate cancer is the second most commonly diagnosed cancer and the second leading cause of cancer death among American men. With an average of 1 in 6 men being diagnosed with prostate cancer in their lifetime, the need to know who is at risk and who should be screened is becoming increasingly important.
What is prostate cancer?
Prostate cancer is the malignant, uncontrolled growth of cells within the prostate gland. The prostate is a walnut-sized gland, which is located below the bladder and in front of the rectum in a male. It wraps around the male urethra, which is the tube that carries urine out of the body. The prostate’s primary function is to produce some of the fluid that nourishes and supports sperm as it exits the body.
Am I at an increased risk of prostate cancer?
Men who are above the age of 50, are African-American, or have an intermediate family member with prostate cancer (such as a father or brother) are at an increased risk of prostate cancer. Studies have also shown that you may be at an increased risk of prostate cancer if you eat a diet high in fat (particularly animal fat) or consume large quantities of alcohol.
Who should get screened?
The American Urological Association recommends that men should receive a baseline PSA (prostate-specific antigen) blood test and digital rectal exam at the age of 40.
Based on the results, your healthcare provider will determine the appropriate frequency for you to continue to be monitored. Men who have a life expectancy of less than 10 years are not recommended to receive screening. For all men, the decision to undergo prostate cancer screening should ultimately be the result of a careful discussion of the risks and benefits between you and your healthcare provider.
What tests are used for screening?
There are two primary tests that are used for prostate cancer screening – a digital rectal exam and a prostate-specific antigen (PSA)blood test. A digital rectal exam involves having a healthcare provider insert gloved, lubricated finger into the rectum to evaluate the size and texture of the prostate gland. The PSA laboratory test is used to measure the level of prostate-specific antigen – a substance produced by the prostate gland – in the blood. The normal range for PSA in general is any value less than 4 nanograms per milliliter (ng/ml) of blood.
What if my test results are abnormal?
An elevated PSA can occur with any of the most common prostate disorders, including prostatitis, benign prostatic hyperplasia (BPH),and prostate cancer. In addition, age, certain medications, trauma, or procedures (such as cystoscopy and prostate biopsy) canals cause an increase in PSA. Therefore, it is important to note that PSA is not specific for prostate cancer, but it is simply an indicator of prostate cancer risk.
If your PSA is considered to be high for your age or if itis increasing steadily, your healthcare provider may recommend a prostate biopsy. This procedure – which is performed under ultrasound guidance -involves having your healthcare provider remove several small samples of your prostate gland for analysis. This testing is the only definitive way to diagnose and stage prostate cancer.
What are the signs and symptoms of prostate cancer?
Signs and symptoms of prostate cancer are generally not apparent unless the cancer is advanced. In advanced stages, you may notice blood in your urine, weakened urinary stream, or difficulty with erection. If the cancer metastasizes (or spreads outside of the prostate), you can experience bone pain in the hips, spine, ribs, or other areas. Any cancer affecting the spine can also cause changes to your spinal nerves, which may lead to weakness or numbness in your lower limbs and loss of bladder or bowel control. This tends to occur with advanced cancer of the prostate.
It is important to note that many other non-malignant disorders can cause similar symptoms. Therefore, you should always discuss your symptoms with a healthcare professional so that they can be further evaluated.
Angelo E. Gousse, MD
Clinical Professor of Urology – Herbert Wertheim College of Medicine – FIU
Voluntary Professor of Urology – University of Miami , Miller School of Medicine
Director of Fellowship:Female Urology,Voiding Dysfunction, Reconstruction
Memorial Hospital Miramar, South Broward Hospital District
1951 SW 172 Avenue, Suite 305,
Miramar, FL, 33029
Tel: 954-362-2720 Fax: 954-362-2761
www.bladder-health.net