Newswise — The simple fact of life for men is that as they age the risk of prostate cancer increases. And, it’s one of those things that men cringe about.
Statistics from the Centers for Disease Control and Prevention (CDC) show increasing risk as men age from their 50s into their 60s and then 70s. With the exception of skin cancer, the CDC says prostate cancer is the most common cancer among men in the United States.
However, the Pennsylvania Prostate Cancer Coalition says prostate cancer is the most common type of cancer diagnosed in Pennsylvania men. Their statistics suggest that 28 men will be diagnosed on a daily basis – 10,240 yearly – and four per day will die from this disease.
Pennsylvania physicians say that prostate cancer doesn’t have to be a death sentence. And for this Grandparents Day, they’re encouraging older men to talk to their physicians about the pros and cons of being screened.
“We want to send a message this Grandparents Day to all grandfathers and older men,” said Bruce MacLeod, MD, president of the Pennsylvania Medical Society. “Talk to your physician about possibly being screened.”
Vincent Fiorica MD, president of the Urological Association of Pennsylvania agrees, and says communication is key.
“The 10-year survival rate for men who are diagnosed at early stages is outstanding,” Dr. Fiorica, who practices urology in Johnstown, says. “Early detection through regularly scheduled age-based or risk-based exams saves lives but it all starts off with a conversation with your physician.”
Enrique Hernandez MD, a board member with the American Cancer Society who is also a trustee at the Pennsylvania Medical Society representing Philadelphia physicians, says that a discussion between older men and their physicians about being screened for prostate cancer should begin at age 50 for those of average risk. For those at high risk including African-Americans and those with a first-degree relative who was diagnosed at an early age, screenings should be discussed at age 45. It’s possible, says Dr. Hernandez, that those at the highest risk should consider screenings at age 40.
“If a patient has decided to be screened, the physician will make arrangements for a test—either a prostate-specific antigen (PSA) blood test or a digital rectal exam,” says Dr. Hernandez.
Despite some anxiety as the patient awaits the test results, says the Urological Association’s Dr. Fiorica, there’s more good news than bad news. Most will be happy with the test results, he says, and those with bad test results will likely survive if they were tested early enough and follow physician-recommended next steps.
“Mortality trends show the percentage of deaths from prostate cancer is decreasing significantly among white, black, and Hispanic men as well as Asians,” Dr. Fiorica says. “This is a cancer in which you don’t have to be a mortality statistic but you need to know your risk level and decide to be screened if you have an average or higher risk level.”
Taking the fight to Harrisburg
Scott Owens, MD, is a urologist in Camp Hill, who says more needs to be done. As such, he helped form the Pennsylvania Prostate Cancer Coalition.
“Our goal is secure grant money much like the breast cancer coalition and through legislation create a prostate cancer task force that will collect data, disseminate info, and be the catalyst for prostate cancer awareness and legislation,” he says.
“The available stats are alarming when you see that in Pennsylvania prostate cancer is the leading cause of male cancer deaths and mortality and is twice as high in black men,” says Dr. Owens, who is also a member of the Pennsylvania Medical Society.
Although only formed in 2012, the Pennsylvania Prostate Cancer Coalition is determined to be heard, and it appears to be doing such.
According to Dr. Owens, a rally will be held at the state capitol on September 16 to support public policy calling for the formation of a Prostate Cancer Task Force to study the impact of prostate cancer in Pennsylvania as well identifying the gaps and needs in men’s health literacy. He anticipates a bill being introduced this fall to form the task force.
Dr. Owens’ group also has an innovative campaign that is helping raise awareness. It’s called “Don’t Fear the Finger.”
“We want this campaign to destigmatize the discussion of prostate cancer screening and treatment,” Dr. Owens says. “It also educates men on the risk factors of prostate cancer and clarifies screening recommendations based on physician and urological input.”
Back in the exam room
Often there are no symptoms of early prostate cancer. This is why having a discussion with your physician to evaluate your risk level is important.
However, there are some hints that your body may be sending you that something isn’t quite right. Dr. Fiorica says men who experience the following may want to let their physician know:
• Urinating too often, particularly at night• Inability to urinate• Weak or interrupted urine flow• Blood in urine• Pain during urination or sex• Pain in the lower back, hips, or thighs
“It’s best to let your physician know,” Dr. Fiorica says. “That conversation you have with your physician could be the first step in a fight against prostate cancer.”
What are the treatments
Dr. Fiorica says that should a screening indicate cancer, treatment plans can vary depending upon the patient. Working closely with a physician-led health care team, a patient can discuss options to determine which would work best for their situation.
In general, there are three options. They include
• Active Surveillance• Surgery• Radiation Therapy
New treatments are in clinical trials, so with time, further options may be available.
Active surveillance is typically considered if the cancer is not growing or spreading. Regular check-ups will be necessary. “If a person is careful about keeping scheduled check-ups and if they’re able to accept the fact that cancer will remain,” says Dr. Fiorica, “then this option gives the patient a little more time to decide what their next steps should be.”
However, says Dr. Fiorica, surgery is often the treatment choice for men with early-stage prostate cancer provided they are in good health. “If the person just wants to get the cancer removed and try to move past the disease, this is often the option they choose,” he says. “Of course, it’s possible that they still may need radiation after surgery and there could be serious side effects they may have to deal with.”
Radiation therapy can be an option for a person who has health problems that prevent them from having surgery, or for high-risk cancer that may grow or spread and thus not likely to be cured by surgery alone.
Key to successfully beating prostate cancer: Patient-Doctor Communications
The good news is that if caught early, prostate cancer is beatable. Most men with early-stage prostate cancer will live many years.
“The average age for men discovering they have early-stage prostate cancer is 65, and 86 percent will still be alive 10 years after treatment,” says Dr. Fiorica. “The key is communicating with your physician from the initial conversation on whether or not to be screened followed by discussions about treatment options if a test comes back indicating cancer.”
PAMED’s Dr. MacLeod echos Dr. Fiorica’s thoughts.
“Sit down with your doctor and talk about the pros and cons of being screened,” Dr. MacLeod says. “Ask questions, know your health history, and take part in your health care.”
This news release is brought to you by the Pennsylvania Health News Service Project, consisting of 18 Pennsylvania-based medical and specialty associations and societies. Members of PHNS include Pennsylvania Allergy & Asthma Association, Pennsylvania Academy of Dermatology & Dermatologic Surgery, Pennsylvania Academy of Ophthalmology, Pennsylvania Academy of Otolaryngology, Pennsylvania American Congress of Obstetricians and Gynecologists, Pennsylvania Chapter of the American College of Cardiology, Pennsylvania Chapter of the American College of Emergency Physicians, Pennsylvania Chapter of the American College of Physicians, Pennsylvania Chapter of the American Academy of Pediatrics, Pennsylvania Medical Society Alliance, Pennsylvania Medical Society, Pennsylvania Neurosurgical Society, Pennsylvania Psychiatric Society, Pennsylvania Society of Anesthesiologists, Pennsylvania Society of Gastroenterology, Pennsylvania Society of Oncology & Hematology, Robert H. Ivy Society of Plastic Surgeons, and Urological Association of Pennsylvania. Inquiries about PHNS can be directed to Chuck Moran via the Pennsylvania Medical Society at (717) 558-7820, [email protected], or via Twitter @ChuckMoran7.
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