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Prostate Cancer - RCJ
Last month I discussed some of the
signs and symptoms of enlargement of the prostate gland in
men. The prostate gland is a small organ in men (about the
size of a walnut) that is located above the rectum and at
the bottom of the bladder. It surrounds the urethra (the
tube that carries urine from the bladder) like a doughnut
and its function is to make a fluid that becomes part of
semen (the white fluid that contains sperm).
Enlargement of the prostate gland is a normal part of
aging. BPH or benign prostatic hypertrophy is not cancerous
but the signs of enlargement (dribbling after urination and
the urge to urinate often, especially at night) are often
the same signs and symptoms of prostate cancer.
We do not know the exact cause of prostate cancer. What
we do know is that there are certain risk factors linked to
prostate cancer. For instance, it is far more common among
African-American men than among white men. A diet high in
fat may play a role and men with a first-degree relative
with prostate cancer are more likely to get prostate cancer
themselves. The greatest risk factor for getting prostate
cancer is age--- as you get older, the chance of prostate
cancer goes up significantly.
Early prostate cancer may
have no symptoms and can only be found with regular
check-ups by your physician. A digital rectal exam should be
performed in all men over the age of 50 and sooner if you
have symptoms of an enlarged prostate at an early age.
Physicians will often do a blood test that measures
concentrations of a protein produced by the prostate called
the Prostate Specific Antigen or the PSA. This may be
elevated in men if cancer is present or if the prostate is
enlarged or infected. The
PSA is also part of the screening process and the risk and
benefits of doing the test should be discussed with your
physician. Most physicians will screen on a yearly basis and
at a younger age if you fall into the high-risk category.
The PSA test is not right all of the
time. For every 100 men over the age of 50 who have the PSA
test, 10 will have a higher than normal level of the protein
and these men must then go through other tests and
examinations. At the end of these tests, only three will
have prostate cancer and of the other 90 men with a normal
PSA level---one or two will actually have prostate cancer
that will cause symptoms. Therefore, the test can create
unnecessary anxiety in some men who do not have cancer and
it will miss some men who do have the cancer
Healthy men without symptoms should
discuss the risk and benefits of PSA testing with their
primary care physician before undergoing testing. All men
should have an opportunity to have the test especially if
they are at high risk for prostate cancer.
There are many treatment options for
prostate cancer; the best one depends on a number of factors
such as age, your overall health and the stage of your
cancer. Each type of treatment has its benefits and
drawbacks. Surgery, radiation, chemotherapy and hormone
treatment are the most common. One possible treatment is
actually no treatment at all. It is termed “watchful
waiting” and it is best suited for men with a life
expectancy of 10 years or less. The idea is that in these
men the cancer is growing so slowly, they likely won’t die
from it and more radical treatments such as surgery might be
more dangerous than simply waiting.
Can Prostate cancer be prevented?
Because the exact cause is unknown it may not be possible to
prevent most cases. Many of the risk factors for prostate
cancer such as race, age and family history is beyond are
control. One possible risk factor that can be changed is
your diet. The American Cancer Society recommends limiting
your intake of high-fat foods and choosing foods rich in the
antioxidant, lycopene. Tomatoes, grapefruit, and watermelon
are rich in lycopenes and may help prevent damage to DNA
thus lowering your prostate cancer risk.
A prostate cancer prevention trial is
currently underway to determine whether medications that
lower androgen levels can reduce prostate cancer
risk. Androgens are male hormones that are known to promote
growth of normal and cancerous prostate cells.
Testing for early
detection of prostate cancer became relatively common this
past decade. As a result, the prostate cancer death rate
has dropped. This may or may not be a direct result of
screening and studies are underway to try to prove that
testing for early detection of prostate cancer will lower
the death rate. Your primary care physician should offer the
option of testing and discuss the potential risk and
benefits regarding early detection of prostate cancer as
well as treatment and side effects of treating prostate
cancer. The more information you know about prostate cancer
the better you are at making decisions about your
healthcare.
Content
of articles can only be used with writer attribution to Dr.
Kevin Weiland.
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