Golden Opportunities

Last month, we focused on women’s health with breast cancer awareness. We don’t want our male viewers to feel left out, so today we’ll turn our attention to prostate cancer. Here to explain its symptoms and treatment is Dr. Mark Belfer, director of Akron General’s Center for Family Medicine.

Question: How prevalent is prostate cancer?

Answer: Prostate Cancer is number one in cancer incidence in American males. 33 percent of all cancer found in American men is prostate cancer.
However, prostate cancer only accounts for 9 percent of all cancer deaths for men. In fact, very few men die from solely prostate cancer-the number is only 3 percent.

Question: What are some of the risk factors?

Answer:

• Men over the age of 50.
• Men from sub-Saharan African descent.
• Men who had a first-degree relative (father/brother) who was diagnosed with prostate cancer under the age of 65. (More than one first-degree relative is even MORE of a risk).
• High-fat diet.
• There seems to be a genetic component (gene mutation).

Question: What symptoms might point to prostate cancer?

Answer: Symptoms include blood in the urine or semen, rectal pain, or a urinary infection.
These symptoms, however, are very non-specific. They can point to many other, non-cancerous conditions as well, like an enlarged prostate.

Question: What screenings are available?

Answer: The main screenings are a PSA (Prostate Specific Antigen) blood test and a digital rectum exam.

Question: I understand that prostate cancer screening is somewhat controversial. Can you explain?

Answer: Prostate cancer is an unusual cancer: If we were to autopsy men who did NOT die of prostate cancer, 70 percent of men over the age of 70 would have cancerous cells. 30-50 percent of men over 50 would have cancerous cells. Most prostate cancers are not terribly virulent, though some terribly are.
The controversy also looks at the screenings themselves-they are not terribly accurate. PSA numbers can be elevated for many reasons, like urinary infections. Other times, they may be low when there actually IS prostate cancer (if the patient is obese, for example). The only way to really know for sure would be to biopsy every man, every year, and that's just not feasible.
The American Cancer Society recommends that men over the age of 50 have the PSA and rectal exam on a yearly basis. They also recommend that doctors and patients discuss the benefits, and the limitations, of screenings. That's a main message I'd like to get across-talk to your doctor!
Of course, men who have had a father or brother with prostate cancer, or African-American men, really should have the screenings.

Question: What about treatment?

Answer: Treatments include chemotherapy, radiation therapy, and surgical removal of the prostate.
As with the screenings, treatment of prostate cancer can be very controversial. Treatment can result in erectile dysfunction or urinary or fecal incontinence. And again-while some forms of prostate cancer are very virulent, others would not be fatal. Sometimes biopsies can tell if there is a virulent type of cancer cell. After the biopsy, treatment can be assessed, or the doctor and patient may decide to simply wait and watch.

If you're a man over 50 or you are married to one, make sure he talks to a doctor about prostate cancer screening. And don't delay if you are at high risk. To learn more, give Akron General a call. My thanks to Dr. Mark Belfer.