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Prostate Cancer Awareness Month
One in six American men will be diagnosed with prostate cancer during his lifetime. It's a more common disease among men than breast cancer is among women. Black men have a 50 percent greater chance of getting prostate cancer than whites and are twice as likely to die from it.
A strong family history boosts a man's risk of getting the disease to one-in-three. Leslie D. Michelson, president and chief executive officer of the Prostate Cancer Foundation, ticks off one striking statistic after the next, unable to overstate the threat posed by the disease. Yet few men recognize the toll that prostate cancer could exact on their health and sexual performance and well-being. Many men feel they're immortal, Michelson said. They're squeamish about discussing a cancer that potentially can affect their ability to have erections. "Prostate cancer is really the last major disease still behind the curtain," he said. "It is only a male disease. It is the male disease."
September is Prostate Cancer Awareness Month, a good time to break the silence. With recent improvements in prostate cancer treatment, greater hope for recovery, and an aging population at risk for the disease, it's more important than ever for men to get routine screenings.
A simple blood test, called a prostate-specific antigen (PSA) test, and a digital rectal exam are the methods used to detect prostate cancer. The American Cancer Society recommends that men receive these tests annually beginning at age 45 if they have a family history of the disease or are black. Men at even greater risk, say, with several first-degree relatives who had prostate cancer at an early age, should begin testing at age 40. Everyone else should be screened beginning at age 50. But some experts now believe testing should begin even sooner to establish an early baseline against which to measure annual PSA results. A study in the July issue of the New England Journal of Medicine found PSA changes over time -- as opposed to an absolute number -- are the most important predictor of a man's risk of dying from prostate cancer.
D'Amico and his colleagues suggest men get a baseline PSA test at age 35 with annual follow-ups after that.
A study released last week by Stanford University researchers called into question the value of PSA testing. Twenty years ago, the researchers said, there was a strong correlation between a high PSA level and prostate cancer because the test was usually done only when a physician suspected cancer. Today, the test is usually done as a matter of routine. Since PSA production is related to the size of the prostate, a high level usually is related to benign prostatic hyperplasia, the harmless increase in prostate size that occurs with aging, the researchers said. If you happen to be one of the 240,000 American men diagnosed with prostate cancer this year, take time to consider the various treatment options, including surgery and radiation. There's no standard treatment, and what's right for you may hinge on your cancer, your age, your overall health and the benefits of a particular intervention versus the risks and side effects.
Prostate cancer typically progresses very slowly, though, and may not demand immediate action, particularly if it isn't producing symptoms. Those symptoms can include difficulty urinating or frequent need to urinate, blood in the urine or semen, or difficulty having an erection. In those cases, the best advice may be to watch and wait. Jim Shaw
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