It’s September, which is National Prostate Cancer Awareness month. Yet this deadly disease deserves attention all year long! Here are the facts:
This makes prostate cancer a very common, and very deadly disease!
Prostate cancer often has no symptoms. Men can’t readily exam their prostate. When we compare this to breast cancer, a self-exam is possible for women. Therefore, the only hope is a proper prostate screening. The statistics for breast and prostate cancer are nearly identical. There is much public awareness surrounding screening, biopsies, and treatment of breast cancer. This awareness needs to be as strong for men and prostate cancer.
The studies have shown that there is only one way to prevent prostate cancer and that is castration prior to puberty. Other more realistic ways to decrease the risk, but not prevent, are the following:
Have I got your attention? Good. Now share these facts with your primary care provider. I am a Duke University Board-certified Urologist. My specialty training was in oncology, specifically prostate cancer. I speak to this subject with authority. This is a misperception amongst primary care providers that prostate cancer is slow-growing and a non life-threatening problem. This was once the way they once viewed breast cancer. Prostate cancer needs the attention and public education that breast cancer has received. My views may differ what you guys may “google,”, but whoever went to Google Medical School? No one! What should you expect, then, from your primary care provider (PCP)? Proper prostate cancer screening.
Men with either an abnormal DRE or a PSA should then undergo a prostate biopsy. What about the risks of screening, the false-positives, and false-negative results? What about finding cancer in a man who may not “need” to be treated? I heard that some treatments may be worse than the disease? This kind of thinking ignores the first two facts that are indisputable!
The “risk” of a PSA is a blood draw! It is illogical to assume that getting a PSA is a “risk” equivalent to unnecessary surgery. That’s like saying getting a mammogram is a risk because it may lead to unnecessary surgery. Screening means early detection. Elevated PSA does not always mean prostate cancer. Elevated PSA does mean that you need a full evaluation by a Urologist. There are standardized approaches to evaluation of an elevated PSA. If a prostate biopsy is necessary, in most cases it is conclusive. Early diagnosis is key. Routine screening starting at age 50 is recommended so that you do not have a small cancer that is left undiagnosed and untreated. The trend is a decrease in Breast cancer mortality as compared to prostate mortality—the reason for this is public awareness education and increased screening for breast cancer. Again screening is necessary for prostate cancer as early diagnosis is the key! Are the treatments dangerous? If you have a biopsy positive prostate cancer, then further evaluation and staging is necessary for treatment decisions to be made by you and your urologist. Are the treatments dangerous? Not as dangerous as an undetected cancer and delay in treatment of early cancer. Treatments can cure men who have organ-confined disease, early diagnosis, nearly always! Options include:
Treatment options have pros and cons that will need to be discussed with your doctor. Men, know that prostate cancer carries the same risk of breast cancer without the possibility of self-screening. Insist that your primary care provider screens appropriately. Make Prostate cancer awareness month a year-long awareness for both patients and their doctors! We do routine PSA and prostate cancer screening blood tests with any hormone replacement (HRT) evaluations.
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