After lung cancer, prostate cancer is the second leading cause of cancer-related deaths among men in the
United States, and the disease will claim approximately 28,000 lives this year, according to the American Cancer Society. Also, the ACS estimates that in 2012, the incidence of new cases of prostate cancer will be approximately 240,000. One in six men over their lifetimes will develop prostate cancer; however, most prostate cancers are not life-threatening.
Due to the prevalence of prostate cancer, “Prostate Cancer Awareness Month” is observed each September in a number of countries around the globe. Also, a blue ribbon is used to promote the cause.
“The exact reasons why men develop prostate cancer are unknown,” said Col. (Ret.) David McLeod, director of the Center for Prostate Disease Research at Walter Reed National Military Medical Center. He and his colleagues explained that certain factors may increase the chances for some men developing the disease. Some of the reasons may be genetics, diet, advancing age, or a combination of factors, stated Lt. Col. Inger Rosner, urologic oncologist at WRNMMC and associate director of the CPDR.
McLeod and Rosner explained that although a healthy diet and lifestyle, which includes regular exercise, may be helpful in reducing men’s chances of developing prostate cancer, awareness of their individual prostate cancer risk is very important.
McLeod, who has successfully treated scores of prostate cancer patients during his more than 40 years of practicing medicine, said men should be aware that the medical community continues to debate the exact age men should begin testing or screening for the detection of prostate cancer. The American Urological Association strongly supports that the decision to be tested for prostate cancer should be individualized and should include a discussion with a healthcare provider about the risks and benefits of testing. Therefore, men can make an informed decision about testing. McLeod states that it is reasonable for discussion about the risks and benefits of testing to start at age 40 for men who are at an increased risk of developing prostate cancer, such as African-American men and men with a family history of the disease. Otherwise, it is recommended that testing be discussed and offered to men beginning at age 50.
Rosner said that detection for prostate cancer is carried out by a digital rectal exam and a blood test for prostate specific antigen. The test measures the level of PSA in the blood; a substance produced by the normal prostate and is usually produced in higher levels by most prostate tumors. All men will have some PSA in their blood, and an elevated PSA does not necessarily mean that a man has prostate cancer.
“With early risk assessment and detection of prostate cancer, we are diagnosing prostate cancer in its earlier stages,” Rosner said. Prior to the use of PSA testing, 21 percent of men at diagnosis had prostate cancer that had spread beyond the prostate (metastatic). Today, it is approximately 4 percent as the majority of men have tumors that are confined to the prostate, and some may not be considered aggressive.
In most cases men with early prostate cancer have no symptoms. This finding explains the importance of the PSA blood test and exam. The National Cancer Institute advises men to consult their physician if they notice:
• a need to urinate often, especially at night.
• difficulty starting or stopping urination.
• a weak flow of urine.
• painful or burning urination.
• blood in the urine or semen.
Any of these symptoms may be caused by prostate cancer, but they are usually not due to cancer.
For men who are diagnosed with prostate cancer, the CPDR conducts a comprehensive, team-focused, patient-centered Multi-Disciplinary Prostate Cancer Clinic. This clinic is an all-day forum of education and physician consultations that, provides men and their Families information about their prostate cancer. A recommended treatment plan is established by a panel of prostate cancer specialists. Thus, patients and their Families are able to make an informed decision on the best treatment for them. Treatment for prostate cancer can take a number of different forms, depending on the patient’s clinical presentation, consultation with his urologist and other specialists, and the stage of the disease. Some men may be candidates for close observation only.
Rosner and McLeod explained forms of treatment for prostate cancer confined to the prostate may include: active surveillance, surgery or radiation. In addition, other therapies may involve cryotherapy and high-intensity focused ultrasound. Hormone therapy may also be used in conjunction with radiation and as a treatment option for more advanced disease found to be outside the prostate.
The CPDR and Urology Clinic will host their annual Prostate Cancer Awareness Day for military beneficiaries Sept. 22 at the CPDR. The CPDR is located on the third floor of the America Building at WRNMMC. For more information, call: 301-319-2900 or email: jane.l.hudak.ctr@health.mil.
(From a Walter Reed National Military Medical Center press release)
