What every man should know about prostate cancer

Having a healthy prostate is important because it affects both sexual and urinary functions. But many men tend to put off regular health checkups and screenings — particularly when it comes to prostate cancer.

The prostate gland is about the size of a walnut and sits just below the bladder and in front of the rectum. Its primary function is to produce the liquid that transports sperm.

According to Dr. David Bodkin, a board-certified oncologist affiliated with Sharp Grossmont Hospital, prostate cancer is the second-leading cause of cancer-related death in men after lung cancer. One in 8 men will develop it in their lifetime.

“As with most cancers, when prostate cancer is caught early, it’s easier to treat and the chances for survival are good,” he says.

Dr. Bodkin recommends men at average risk begin screening at age 50 with an initial prostate exam and discussion of personal and family health history during their physical exam. They should then continue to be screened every 1-2 years, depending on their prostate specific antigen (PSA) level, a gage for a certain protein that when high, can be a sign of cancer.

For men who are at higher risk, including those with a family history of prostate cancer and African American males, initial screening is recommended at age 45. According to the American Cancer Society, prostate cancer develops more often in African American men and in Caribbean men of African ancestry than in men of other races. They are also more than twice as likely to die from prostate cancer and are more likely to be diagnosed at an advanced stage. The reasons for this disparity are complex and include interactions between social, behavioral and biological factors.

Screening can help detect symptoms before they start, and Dr. Bodkin says it’s important for men to talk to their doctor about the pros and cons of screening and what’s right for them. A growing number of experts feel that prostate cancer is slow-growing, and many men who have it may never develop cancer or even know they have the disease until they’re screened.

The prostate cancer screening test used, a prostate-specific antigen (PSA) blood test, alerts doctors to the presence of cancer, but there’s no definitive way to determine whether it will ever cause symptoms or harm. Therefore, the benefits and disadvantages of treatment should be weighed carefully.

Top questions about prostate cancer, answered

Here, Dr. Bodkin answers 7 common questions about prostate cancer:

1. What are the symptoms of prostate cancer?
   Symptoms include weak urine flow, decreased sexual function, painful urination, frequent nighttime urination, and presence of blood in the urine or semen. However, in some instances, there are no symptoms at all, which is why screening is important.

2. What are the risk factors?
   The most common risk factor is age. The older a man is, the greater the chance of getting prostate cancer. Also, men who have a family history of prostate cancer are at higher risk.

3. What is watchful waiting?
   Because prostate cancer often grows very slowly, some men — particularly those who are older or have other serious health problems — don’t receive treatment and opt for observation. This is known as watchful waiting, or active surveillance, and usually includes regular monitoring, follow-up doctor visits and testing at regular intervals.

4. What is a PSA blood test?
   A prostate-specific antigen (PSA) blood test measures the level of a protein called prostate-specific antigen, which is made by cells in the prostate. The chance of having prostate cancer goes up as the PSA level goes up, but there is no set cutoff point that can tell for sure if a man does or doesn’t have prostate cancer. If your PSA level is high, you might need further tests to look for prostate cancer.

5. How is prostate cancer treated?
   When a biopsy is done and reveals cancer, a pathologist provides information, such as aggressiveness, extent of invasion, grade and other details that factor into treatment options. A few common options include active surveillance, surgery and radiation therapy. For higher stage disease, treatment may also involve targeted and systemic therapies, including hormonal therapy or chemotherapy, as well as immunotherapy.

6. Are there any lifestyle changes, such as diet or exercise, that could help reduce risk?
   Eating a balanced diet that includes plenty of fruits and vegetables; avoiding or limiting red and processed meats as well as fatty foods; and keeping physically active to maintain a healthy weight can help decrease risk.

7. Are there any new advancements in the detection of prostate cancer?
   Analysis of pathology has changed and become more sophisticated. It is now more than a pathologist looking at a biopsy. The specimen can be sent for analysis of genes — both inherited and acquired mutations in DNA — that are valuable when determining how aggressive the cancer may behave.

Learn more about prostate cancer care at Sharp.

For the news media: To talk with Dr. David Bodkin, board-certified oncologist, about prostate cancer for an upcoming story, contact Erica Carlson, senior public relations specialist, at erica.carlson@sharp.com.