Recent news article have suggested that healthy men don’t need to have routine prostate screenings. At first you might say, “Well I’m healthy. Maybe I’ll skip it this time.” Should you? A few years ago the United States Preventive Services Task Force said in a report that routine “prostate-specific antigen” (PSA) screenings does not save lives. Their conclusion was based on five major clinical studies. The two largest studies conducted in the U.S. and Europe found that the death rates of men who got prostate screenings were virtually the same as those who didn’t. Is this reason enough not to have a routine prostate screenings?
What most people and even some doctors don’t understand is that a PSA screening is not a specific test for cancer. It’s a test that can detect abnormalities. It doesn’t identify a particular problem. One doctor put it this way “A PSA screening is like an engine warning light. When it flashes, you can’t tell if a particular spark plug is bad. It tells you only that something needs to be looked at.”
About two-thirds of men with an elevated PSA don’t have cancer. They may have an inflamed or infected prostrate. They could have a prostate gland that’s larger than normal (benign prostatic hyperplasia, or BPH). PSA levels normally increase with age. PSA screening only alert doctors there is a problem. It may not be cancer.
According to the CDC PSA levels also can be affected by:
• Certain medical procedures
• Certain medications
• An enlarged prostate
• A prostate infection
Most men don’t know where or what their prostate is. The prostate a small gland that is, about the size and shape of a quail’s eggs. The prostate gland is nestled in the pubic bone area and surrounded by the pelvic muscles. The prostate gland will respond to pressure applied through the rectum. The main function of the prostate is reproduction. The testicles produce sperm, which is carried by the vas deferens to the prostate, where it mixes with fluid from the prostate and seminal vesicles. This fluid is comprised of 5% sperm and 95% seminal/prostate fluid.
Most labs consider the normal range for PSA to be between zero and 2.5 nanograms per milliliter (ng/mL) of blood. Cancer cells release about 10 times more PSA into the blood than normal prostate cells. This is why an elevated PSA reading is worrisome. If your PSA test comes back elevated you should repeat the test to see if the numbers stay the same. Even if the first test was accurate, the numbers could be transitory. A high PSA often will return to normal when any underlying condition clears up.
If your PSA tested high you should get tested at least twice a year. If your numbers dropped you should monitor your numbers about once a year. If your numbers are still high there may be an underlying problem. Cancer may be one possibility. A progressive increase of PSA over time known as velocity is a more troubling issue than a single high reading. The larger the jump in your PSA, the greater your risk of cancer.
The prostate gland is located just below the bladder. Cancer of the prostate involves the enlargement of the gland. Although 50% or more of all US males after age 55 have enlarged prostate glands, any enlargement should be checked. Prostate enlargement does not in itself mean cancer.
Prostate cancer symptoms include:
• Weak or interrupted urine flow
• Inability to urinate or difficulty in starting or stopping urination
• Need to urinate frequently, especially at night
• Blood in the urine
• Painful or burning urination
• Continuing pain in the lower back, pelvis or upper thigh
If any of these symptoms are noticed, you should contact your doctor.
Men with an enlarged prostate gland and men over should have a digital rectal exam. With a digital rectal exam, the doctor inserts a gloved, lubricated finger into the rectum to feel for any irregular or abnormally firm areas. After age, 50 men are urged to have a prostate specific antigen (PSA) blood test annually. African Americans and people at high risk should be tested two to three times a year. A prostate ultra sound can reveal cancer growth that might be too small to be detected by physical examination. This test is recommended for African Americans and men at high risk for prostate cancer.
If a growth is found you should receive, more testing that can include special x-rays, urine analysis and blood test. If the test is positive, the doctor will recommend a biopsy. A biopsy is the removal of small piece of tissue from the tumor. This will determine if the growth is benign or malignant.
The treatment of prostate cancer can include surgery, hormone treatments, radiation and anti-cancer drugs. The type of treatment depends on the stage of the cancer, age and health.
During the early stages of prostate cancer, the cancer is confined to the prostate gland and cannot be felt during a rectal exam. Early prostate cancer in most cases receives little treatment, but the patient is advised to return for regular follow-up exams. Localized prostate cancer is still confined to the prostate gland. These tumors are large enough to be felt during a rectal exam. Regionalized prostate cancer has spread into the tissue surrounding the prostate gland. Advanced prostate cancer has spread to the lymph nodes in the pelvis or to other body structures. Prostate cancer cells most often will spread to the bone from the prostate area.
If the cancer is detected early and it’s localized to a small area surgery or radiation therapy can be used. During surgery, the prostate gland is removed. This surgery can cause impotency and some urinary problems. The aim of radiation is to destroy the cancer cells by affecting the cancer’s ability to reproduce. Some side effect may include increased bowel or bladder activity. Radiation treatment caused impotency in 30% to 50%.
Hormone treatment can be used to control the cancer for long periods by shrinking the size of the tumor though the control of the male hormone testosterone. This treatment can include the removal of the testes or by giving the patient estrogen to counteract the testosterone. The male hormone testosterone stimulates the growth of prostate cancer. Reducing the size of the tumor can relieve a lot of the pain associated with prostate cancer.
Chemotherapy is the treatment of cancer with anticancer drugs. This treatment can also reduce pain and slow down the growth of prostate tumors. Chemotherapy does have side affects. These side affects include nausea, vomiting, hair loss, anemia, reduced ability of your blood to clot and the increased likelihood of developing infections and mouth sores.
Men diagnosed with localized prostate cancer on average have a five-year survival rate of 94%.
Some cancers can be prevented with a change in lifestyle. Here are some changes that will go a long way in helping to reduce the risk of cancer.
1. Reduce your fat intake.
2. Limit your sodium intake to no more than 1200 mgs a day.
3. Eat less processed foods.
4. Reduce your body fat.
5. Eat 3 to 5 servings of fruits daily.
6. Eat 4 to 6 servings of whole grain foods daily.
7. Eat no less than 3 servings of vegetables daily.
8. Get into an exercise program.
9. Get an annual check-up.
For more information about prostate cancer, contact The American Cancer Society.