By Quinton V. Cancel, MD
Men, September is Prostate Cancer Awareness Month, so now is a great time to learn some important health facts and answer some common questions about prostate cancer.
Did you know that, after skin cancer, prostate cancer is the most common cancer in American men?
According to the American Cancer Society, over 191,000 men will be diagnosed and over 33,000 men will die from prostate cancer in 2020, making it the second leading cause of death behind lung cancer. Even though 1 in 9 men will be diagnosed with prostate cancer in their lifetime, most men will die with prostate cancer than from it.
So who is at greatest risk?
African American men, men over 60 years of age and men who have a first-degree relative (i.e., brother, father, son) with prostate cancer are most at risk.
How do I get tested for prostate cancer?
The screening for prostate cancer consists of two items: a simple blood test called the prostate-specific antigen (PSA) and a digital rectal exam (DRE). Both tests are required for proper screening.
What happens if my PSA or DRE is abnormal?
You should have a talk with a urologist to determine if the next steps in diagnosis are appropriate. Generally speaking, if you have a less than a 10-year life expectancy, no further action is required. However, if you are healthy and want to pursue a diagnosis, getting a prostate biopsy or an MRI are the appropriate next steps.
What is a prostate biopsy?
It is an office procedure that takes roughly 5 minutes to perform. After an enema prep at home and receiving antibiotics before the procedure, your urologist will place an ultrasound probe via the rectum to visualize the prostate and usually numb the prostate with lidocaine before taking 12 small samples from both sides of the gland. No driver is required. You may notice a small amount of blood in your semen, urine or when you wipe after using the bathroom, but this usually resolves quickly.
How is an MRI used in the workup for prostate cancer?
A multiparametric MRI is a special MRI imaging study that can help identify areas in the prostate suspicious for more aggressive prostate cancer. It is noninvasive and painless. If positive, the images can be fused to an ultrasound to give real-time data that can guide the urologist in targeting those specific areas to help make the diagnosis. This is done under general anesthesia as the patient cannot move during the procedure.
What are my treatment options if I’m diagnosed with prostate cancer?
Strategies for treating prostate cancer range from active surveillance (monitoring only) to definitive treatment with robotic surgery or radiation to other options in between. This is a personal decision that should be made once you have been thoroughly advised and understand the risks and benefits of each option and have discussed it with your loved ones.
Remember, prostate cancer is completely curable if found early. So guys, let’s get checked!
Quinton V. Cancel, MD, is a urologist with Mission Urology.