September is Prostate Cancer Awareness Month. Lake Regional Urologist Eric McQueary, D.O., is encouraging men to learn more about this disease so they can make informed decisions about their health with their doctors.
According to the American Cancer Society (ACS), about one in nine men will be diagnosed with prostate cancer during their lifetime. For African American men, the number is even higher — one in seven.
“Prostate cancer is second only to lung cancer as the leading cause of cancer death in American men,” Dr. McQueary said. “Still, most men diagnosed with prostate cancer won't die from it. That's because prostate cancer is often very slow-growing. This means men need personalized care based on their health situation and risk tolerance.”
Finding prostate cancer
Most prostate cancers are diagnosed as a result of screening with either a digital rectal exam or prostate-specific antigen (PSA) blood test. Prostate cancer usually doesn't cause symptoms in its early stages.
PSA in the blood is measured in nanograms per milliliter (ng/mL). The likelihood of having prostate cancer rises with the PSA level. But there is no firm number that indicates prostate cancer. Some, but not all, doctors use a cutoff point of 4 ng/mL or higher when deciding whether a man should undergo further testing.
If your doctor suspects prostate cancer, the most likely next step is a prostate biopsy, in which small samples of prostate tissue are removed and sent to a lab for analysis.
The ACS recommends that men work with their doctors to make an informed choice about getting screened with a PSA test. This discussion should occur at:
- Age 50 for men at average risk for prostate cancer who are expected to live at least 10 more years.
- Age 45 for men at high risk. This includes African American men and men with a father or brother diagnosed with prostate cancer before age 65.
- Age 40 for men at higher risk. This includes men with more than one first-degree relative who was diagnosed with prostate cancer at an early age.
“You should have a discussion with your doctor about the pros and cons of prostate cancer screening,” Dr. McQueary said. “Screening can help find many prostate cancers early, but it is helpful to fully understand how your results will be processed and possible treatment options.”
Staging and treating the cancer
If the biopsy results don't show cancer, you may not need further testing for now. But if the biopsy results indicate cancer, the next step is determining what grade the cancer is. Almost all cancers are grade 3 or higher. The highest grade is 5.
If a prostate cancer is small and low-grade, a doctor might suggest actively monitoring it to see if it grows. Other treatment options include:
- Surgery. When surgery is needed, Dr. McQueary generally uses Lake Regional’s da Vinci X robotic surgery system.
- Radiation therapy.
- Hormone therapy.
- A combination of the above.
“It's important to thoroughly review all your treatment options with your doctor,” Dr. McQueary said. “Your plan of action should depend on the stage of cancer, your age and other factors.”