Tag Archives: PSA

Prostate Cancer Awareness for 2019

Introduction

This post is for Prostate Cancer Awareness Month. We offer answers to a few questions and additional resources. The first is this video from the Center for Disease Control and Prevention (CDC) about whether you should get tested for prostate cancer.

Basic Facts

Men (and those who care for men – meaning everyone) should be knowledgeable about prostate cancer. I don’t mean physician-level knowledgeable, but there are just a few facts that you should know that are meaningful. We’ll cover those in this Straight, No Chaser.
Aside from skin cancer, prostate cancer is the most common cancer among men in the U.S. It is also one of the leading causes of cancer death among men of all races. According to the National Cancer Institute, in 2018, there will be over 164,6900 new cases and well over 29, 430 deaths (13% increase from 2017) from prostate cancer. Approximately 11.2% of men will be diagnosed with prostate cancer at some point during their lifetime. Here are some prostate cancer basics.
Prostate NormalCancer

Who’s at risk for prostate cancer?

  • Age: This is simple. The older you are, the greater your risk of developing prostate cancer.
  • Race: Prostate cancer is more common in certain racial and ethnic groups.
  • Genetics: This risk is twice to three times more likely if you have a father, brother or son who has had prostate cancer. This is not the same as saying you’ll develop prostate cancer if a family member did.

What are the symptoms of prostate cancer?

prostate cancer symptoms

It is of interest that a wide variety of presentations exists in those later diagnosed with prostate cancer. Some men don’t have symptoms. In these cases, prostate cancer is discovered on screening examinations. Other men present with several symptoms, often including the following.

  • Blood in the urine or semen
  • Difficulty completely emptying the bladder
  • Difficulty starting urination
  • Frequent urination (especially at night)
  • Pain in the back, hips, or pelvis that doesn’t go away
  • Pain or burning during urination
  • Painful ejaculation
  • Weak or interrupted flow of urine

What Is Prostate Cancer Screening?

Cancer screening means looking for cancer before it causes symptoms. The goal of screening for prostate cancer is to find cancer early that may spread if not treated.

There is no standard test to screen for prostate cancer. Here are two tests that are commonly used to screen for prostate cancer.

  • A blood test called a prostate specific antigen (PSA) test. PSA is a substance your prostate makes. This test measures the level of PSA in your blood. Your PSA level may be high if you have prostate cancer and for many other reasons, such as having an enlarged prostate, a prostate infection, or taking certain medicines.
  • Digital rectal examination, when a health care provider inserts a gloved, lubricated finger into a man’s rectum to feel the prostate for anything abnormal, such as cancer.

How Is Prostate Cancer Treated?

Prostate-Cancer-Treatment

See the above chart for more detailed information. Optimally, treatment for prostate cancer should take into account

  • Your age and expected life span with and without treatment
  • Other health conditions you have
  • The severity (i.e. stage and grade) of your cancer
  • Your feelings (and your physician’s medical opinion) about the need to treat the cancer
  • The likelihood that treatment will cure your cancer or provide some other measure of benefit
  • Possible side effects from treatment

Different types of established treatments are available for prostate cancer, including the following:

  • Closely monitoring the prostate cancer by performing prostate specific antigen (PSA) and digital rectal exam (DRE) tests regularly, and treating the cancer only if it grows or causes symptoms. This is called active surveillance.
  • Surgery to remove the prostate and or surrounding tissue. This surgery is called a prostatectomy.
  • Radiation therapy with high-energy rays to kill the cancer..
  • Hormone therapy perhaps could be named “hormone blocking therapy.” These medicines blocks cancer cells from getting the hormones they need to grow.

There’s More!

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Straight, No Chaser: Prostate Cancer Screening

prostate-to-do-2

Every so often, controversies regarding medical treatment recommendations get in the news and seemingly only serve to confuse the public. Every blog, article or research paper is a single entity that may or may not adjust the body and weight of evidence on a given topic. Even most well-done research articles do not completely change the standard of care for medical practice. Prostate cancer screening is a great example. At the end of it all, controversies aren’t as important as the consensus recommendations that emerge from medical and public health professionals tasked with reviewing such information.
In this Straight, No Chaser, we will review the current recommendations from the American Cancer Society (ACS) for early detection of prostate cancer. Remember, when you hear dissenting views, consider the source and balance that against the formal recommendations of ACS.
In an earlier Straight, No Chaser, several questions regarding prostate cancer were addressed. However, there is one additional question that is important to review.
Does Everyone With Prostate Cancer Get Treated?


prostate screening risks benefits

This is the source of controversies regarding screening of prostate cancer. Most men diagnosed with prostate cancer do not die from the disease. I mentioned previously that 30,000 men with prostate cancer die of the disease every year. However, over 2.5 million men in the U.S. are currently living with a diagnosis of prostate cancer. Based on these statistics, the question then becomes…

Why Do All Men Need to Be Screened For Prostate Cancer?
A certain stream of logic asks why screening is necessary if most of those who are diagnosed don’t die. Many treatments (e.g. surgery, medications, radiation) have additional risks that could be avoided if interventions were avoided. Similarly, some have taken to asking if any screening program is necessary. The view here is information is empowering. It’s always better to have information regarding the state of your health. Working with your medical team and family, the correct decisions about next steps can be made. This option is only available if you know what’s happening with your health.
How Does Screening Occur?

prostate exam

There are two tests commonly used to screen for prostate cancer.

  • A digital rectal exam (DRE) is when a doctor inserts a gloved, lubricated finger into the rectum and estimates the size of the prostate and assesses it for lumps or other abnormalities.
  • The prostate specific antigen (PSA) test measures the level of PSA in the blood. PSA is a substance made by the prostate, and PSA blood levels can be higher in men who have prostate cancer. Unfortunately the PSA level isn’t specific for prostate cancer, as it can be elevated in other conditions that affect the prostate such as age, race, certain medications or medical procedures, prostate enlargement or infection.

So What Are The Current Recommendations for screening?

prostate cancer screening guidelines

The American Cancer Society (ACS) recommends that men get to decide if they want to be screened, based on a recommendation from their physician and having received information about the risks, benefits and uncertainties surrounding screening. In other words, we don’t even talk about screening anymore; now it’s “Who should have a conversation with their physician about getting screened?”

  • If you’re age 50 and have an average risk of prostate cancer and are expected to live at least 10 more years. Because prostate cancer grows slowly, if your life expectancy is less than 10 years, you wouldn’t benefit from screening or treatment for prostate cancer.
  • If you’re age 45 for men and are at high risk of developing prostate cancer. This includes African-Americans and men who have a first-degree relative (father, brother, or son) diagnosed with prostate cancer at an early age (younger than age 65).
  • If you’re age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age).

Among these groups, when the decision is made to screen, those men will be tested with the prostate-specific antigen (PSA) blood test. The digital rectal exam (DRE) may also be done as a part of screening.
Assuming no prostate cancer is found as a result of screening, the need for future screenings depends on the results of the PSA blood test:

  • Men who choose to be tested who have a PSA of less than 2.5 ng/ml, may only need to be retested every 2 years.
  • Screening should be done yearly for men whose PSA level is 2.5 ng/ml or higher.

Please at least have the conversation with your physician.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offer. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
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From the Health Library of SterlingMedicalAdvice.com: "What’s a PSA test, and why is it important?"

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Prostate-specific antigen (PSA) is a protein that is secreted from the prostate gland. It is important marker of disease. The higher the PSA level, the more likely it is that prostate cancer is present (this is not the same as saying that if your PSA level is high, you have or will have prostate cancer). It is useful and important as a screening tool and a monitor for prostate cancer recurrence after treatment or response to treatment.
According to the American Cancer Society, the following groups of men should consider having a PSA test.

  • Those at age 50 if they are at average risk of prostate cancer
  • Those at age 45 if they are at high risk
  • Those at age 40 if they are at very high risk (those with first-degree relatives who had prostate cancer at an early age)

Please discuss the value of prostate cancer screening with your physician. There is a fair amount of controversy about the test, which is why having the test done is a ‘consideration’ instead of a must. The specifics of this can be discussed with your physician or personal healthcare consultant at SterlingMedicalAdvice.com.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.