Prostate cancer is one of the most common cancers diagnosed in American men

Close to 200,000 new cases of prostate cancer are discovered every year and close to 30,000 deaths are expected every year. It is the second leading cause of non-skin cancer death in men after lung cancer.  Fortunately, although prostate cancer does not cause death in men with the disease, early diagnosis and treatment can be key for saving lives.

Function of the prostate

The prostate is a gland smaller than a golf ball whose purpose is to make and store seminal fluid that nourishes sperm. After the reproductive years, the prostate has little function but does tend to cause problems due to enlargement and blockage of the urinary stream as well as being a source of cancer.

Symptoms and diagnostics of prostate cancer

The patient is often asked if there are any symptoms of prostate cancer. Most men diagnosed with prostate cancer will have no symptoms. In fact when symptoms such as urinary blockage or pain result, often times the cancer is in an advanced stage already. The strongest risk factor for prostate cancer is family history and men with a first-degree male relative with prostate cancer are often screened earlier in life. Men of African-American descent also tend to have a higher rate of cancer diagnosed at an earlier age and thus screening is recommended at an earlier age.

Screening for prostate cancer is accomplished with two tests and is recommended to start at age 50 for most men, age 45 for African-American men and 5 years early for any man with a family history of prostate cancer. The first test is a physical exam in which a doctor will feel the prostate through the rectum. This type of examination will discover anywhere between 5% and 15% of new cases of cancer. In addition of the physical exam, a blood test called the prostate-specific antigen or PSA test has been used for over 20 years. The PSA test is a blood test that measures a protein that is made by the prostate. This level, when high, can indicate which patients are at risk for prostate cancer. In addition to prostate cancer, an enlarged prostate or prostate infection can also cause an elevated PSA level. A PSA level over 4.0 is considered high and identifies men at risk for prostate cancer. For men under the age of 60, however, PSA levels should be closer to 2 or 3 and should be sometimes evaluated with further testing even if though the level is below 4.

PSA Testing for prostate cancer and controversy over its use

The PSA test has come under increased scrutiny in the media and based upon recommendations from the United States Preventive Health Task Force which has caused some confusion on its use.

We believe that the PSA test can be an important tool but does not replace the important conversation between physicians and patients when it comes to prostate cancer screening and the implications of over diagnosis and overtreatment. The PSA test has been a valuable resource in identifying men with aggressive prostate cancer early in the disease and has undoubtedly saved lives. It is also true that some men have been over diagnosed and perhaps more aggressively treated in their cancer than would warrant. A good patient-physician relationship in making sure that patients are not over treated and screening is done appropriately.

Prognosis of prostate cancer

Not all patients with prostate cancer have the same outcome. In many men, the cancer can be slow growing and not require treatment at all. Other men may have a more aggressive form of the cancer and be counseled to receive treatment that can include radiation therapy, cryotherapy, proton beam therapy, or surgical removal of the prostate. The specific treatment that is right for particular man depends on many factors including age and health status of the man and aggressiveness of the cancer. The survival rate for all stages of prostate cancer can be as high as 90% and the complications of treatment can be minimized if stage and aggressiveness of the cancer is appropriately matched to the patient’s treatment.

Contact our Austin Urologists to learn more about prostate cancer and prostate cancer screening.