7 facts about prostate cancer
Testing and treatment are tailored to fit the individual patient
Generally, men find out they have prostate cancer not from noticing a symptom, but from a routine screening by their primary-care provider.
The screening involves a blood test for PSA, or prostate-specific antigen, and a rectal exam to check for prostate surface irregularities, explains Upstate urologist Joseph Jacob, MD. Jacob specializes in treating cancers of the urinary tract and the male reproductive organs.
The prostate is the male reproductive gland that surrounds the urethra, the tube that empties the bladder, and it produces a fluid for semen. The prostate can develop cancer later in life, typically in a man’s 60s or 70s.
Jacob offers these points about how prostate cancer is detected and treated:
- Primary-care doctors and urologists tailor the frequency of testing and aggressiveness of treatment to the individual’s risks, needs and desires.
- When to start screening is generally around age 55, but doctors may recommend it earlier based on risk factors.
- PSA level above 4 nanograms per milliliter generally signals that further prostate cancer investigation is needed. PSA levels can vary widely and do not guarantee that cancer is present, but the test does help catch cancer early, when it is more treatable.
- A prostate biopsy is often the next step after a high PSA reading. A bit of prostate tissue is extracted through a needle, then examined under a microscope to confirm whether cancer is present and how aggressive it is.
- In most cases, where the cancer has not spread beyond the prostate, it can be successfully treated with radiation, surgery or, if slow-growing, with “active surveillance” — just being watched. The most common surgical option is prostate removal, performed laparoscopically through small incisions with robotic assistance. Patients usually go home the same day or after an overnight stay.
- Any treatment runs the risk of affecting sexual function and urinary issues, at least temporarily, and this must be discussed with the patient beforehand. These risks have lessened in recent years.
- There is no proven diet to prevent prostate cancer, so doctors recommend the same thing as for overall good health: a sensible diet, regular exercise and not smoking.