10 Things Doctors Want You to Know About Prostate Cancer
Prostate cancer survival rates are way up—at 99% a decade after diagnosis—thanks to better detection and treatment. But the disease still ranks as the second-leading cause of cancer death among men, with almost 27,000 Americans expected to die from it in 2016, and 180,890 expected to be diagnosed. About one in seven men will face prostate cancer at some point in their lives. So what do doctors want you to know about how to prevent it—or if you have it, to fight it?
Keys to Battling a Common Killer https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/thumbnail/580x388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2Fb1%2F63%2F8b8ddc9941a89ad6c771a618a46f%2Fresizes%2F1500%2Fimage-getty-565975257.jpg
“Prostate cancer is only curable when found early,” says Dr. Ashutosh Tewari, chair of urology at Mount Sinai Hospital in New York. Yet, early-stage prostate cancer “has no symptoms.” To find it, the American Urological Association recommends men have screenings with a digital rectal exam and a PSA blood test annually from ages 55 through 70. The routine PSA has become controversial due to mixed research supporting its effectiveness, says Dr. John W. Davis, prostate specialist at the University of Texas MD Anderson Cancer Center, so talk to your doctor to see if this test is right for you.
“Consult your doctor regarding routine screening.” https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/thumbnail/580x388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2Ff0%2F1c%2F1d64644042e8a5fcf55bf80306ca%2Fimage-getty-509275059.jpg
“Men should know their risk group,” says Dr. Davis. Men who have a close family relative—an uncle, brother or father—who had prostate cancer are at higher risk. So are African Americans. If you have either risk factor, get screened starting at age 40 to 45 with a PSA blood test and digital exam.
“Family history and African ancestry put you at higher risk.” https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/crop/1000x669%2B0%2B0/resize/580x388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2F27%2Fe4%2F1be9c58b47f0836043df9713904b%2Fimage-mans-hands-on-laptop-computer.jpg
The PSA can have high readings for reasons other than cancer, such as prostate enlargement, infection or inflammation, says Dr. Alvin Goh, urologist at Houston Methodist Urology Associates. If these other reasons are ruled out, urologists can do newer tests, such as the urinary PCA3 test or other blood tests, or use MRI and CT scans to see inside your prostate before deciding whether to do a biopsy.
“Not all abnormal test results require a biopsy.” https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/thumbnail/580x388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2Fab%2F5e%2Ffd56120d4db4afe0288e0b085d2e%2Fimage-getty-548557045.jpg
At one time, all prostate cancers were treated with surgical removal of the prostate or radiation. But today, low-grade, minimally aggressive tumors are more often treated with a wait-and-watch approach called “active surveillance,” says Dr. Edward Schaeffer, chair of the urology department at Northwestern Memorial Hospital. He calls this the “biggest advance in prostate cancer treatment today.” Doctors will monitor your cancer, leaving it be if it doesn’t grow. This saves unnecessary treatment—and its side effects.
“Not all cancers require treatment.” https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/thumbnail/580x388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2F5a%2F8d%2F972afc274c0bb14a7b26e96b987e%2Fimage-isk-15850447.jpg