Prostate cancer is the most common type of cancer among men. About one in eight will be diagnosed during their lifetime. It’s also the second leading cause of cancer death among American men.
Part of the problem is there are no symptoms in the early stages of prostate cancer. This means that only testing for it can detect a problem while it’s the most treatable. That’s why prostate cancer screenings are critical.
The National Comprehensive Cancer Network (NCCN) recommends men start screening for prostate cancer at the age of 45. For the past several years, Will Lowrance, MD, a urologic oncologist in our Greenville market, has been part of an NCCN panel that helps set those guidelines.
Check out this Q&A with Dr. Lowrance on the most commonly asked questions he gets about prostate cancer and screenings.
Q: When should I start testing for prostate cancer?
A: Men at average risk should probably start screening around age 45 and continue that through age 75. However, if you’re someone who is at higher risk for prostate cancer – meaning you’re African American, have a first-degree relative who was diagnosed with prostate cancer or even a close relative with breast or ovarian cancer – then you probably should start screening earlier, at around age 40.
Ultimately, men should have a discussion with their primary care provider or urologist about screening so they can make an informed decision about the right time to start. The point of screening men is to find significant prostate cancers, meaning those that may impact their health. Oftentimes, we find low-risk prostate cancers that do not need aggressive treatment.
Q: How do medical professionals screen for prostate cancer?
A: Typically, the screening involves a blood test to check prostate-specific antigen (PSA) levels. The problem is PSA isn’t specific to prostate cancer – it can be elevated for a number of reasons besides cancer.
So, we typically do the test in addition to a rectal exam that allows the provider to feel the prostate and any irregularities that may be present. Today, we’re also doing more prostate-specific MRIs for men who end up having elevated PSA levels.
In my opinion this is the future of how we’re going to better screen for prostate cancer, because instead of jumping right to a biopsy, we can do the MRI to better gauge the risk of a worrisome prostate cancer.
Q: Does prostate cancer have symptoms that would allow someone to detect it in themselves?
A: Unfortunately, early-stage prostate cancer does not usually present with symptoms. Prostate cancer is one of the silent diseases – approximately 80 percent of all prostate cancers diagnosed in the U.S. are localized and typically have no symptoms associated with them.
When men do start to feel symptoms, like weight loss or bone pain, that tends to mean they’re already in a very late stage of the disease. So, it’s already spread and is causing problems.
Q: Is prostate cancer a death sentence?
A: Not at all. While it is a common disease among men, the reality is a lot of those prostate cancers that men develop will have no impact on them in their lifetime.
On average, there are 33,000 men in the U.S. who do develop more advanced prostate cancer and die every year. However, this is why we think screening is so important. It’s a crucial part of decreasing the mortality rate of this disease.
Q: Is prostate cancer preventable?
A: There’s nothing widespread that we recommend. There have been a number of studies looking at everything from vitamin D to dietary changes, but nothing has really been proven to help with prevention up to this point.
However, I tell my patients that a healthy lifestyle can only help. Often, men come to see me really worried about their PSA being high and potentially having prostate cancer. However, it turns out they have other medical things going on – high blood pressure, diabetes, etc. So, while I can’t say having a healthy diet or an exercise routine will decrease your chance of prostate cancer, I’m confident it helps other physical factors that would play into how we would treat someone’s prostate cancer down the road.
Q: If someone has been diagnosed with prostate cancer, what are the next steps?
A: Your urologist will talk to you about what type of prostate cancer you have. If it’s one that’s more indolent (not very aggressive), treatment may not be needed and can just be watched. If it’s one of the more serious ones, we will have a discussion about the various treatment options – which can include surgery, radiation, hormone therapy, chemotherapy or others.