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Published on June 30, 2017

Prostate Cancer

What is it, and should I be screened?

Sources: Dr. David Deholl, Dr. Scott Donaldson, and Dr. W. Glover Little of Pardee Urological Associates

Before we dive into the details, let’s discuss first what exactly the prostate is. The prostate is a relatively small organ that is located behind the bladder of all men. The prostate is primarily a reproductive organ which produces a large volume of the male ejaculate. Once a male is finished having children, his prostate is no longer needed. The prostate is a hormone sensitive organ that is stimulated by testosterone. Unlike women, who go through menopause and experience a rapid drop in hormones, men continue to produce testosterone which stimulates the prostate. This sustained stimulation causes problems, a lot of problems.

Prostate cancer currently affects roughly 1 out of every 7 men. It is the second most common type of cancer for men next to skin cancer. Prostate cancer affects predominantly older men, typically aged 65 and older. Prostate cancer is rare in men under the age of 40. Often times prostate cancer can be very slow growing and may not be life threatening. For example, even though roughly 1 in 7 men will be diagnosed with prostate cancer, only 1 in 39 will die of this disease. However, certain types of prostate cancer can be very lethal and aggressive. The only way to discern between the two is through screening and surveillance. Prostate cancer can often have almost no symptoms, particularly in the early stages. If symptoms do present, they are generally in the form of difficulty urinating and/or having to urinate frequently. Some factors can increase your risk of prostate cancer including living an unhealthy lifestyle and having a family history of prostate cancer.

Prostate cancer is detected in a number of different ways. The most common way that physicians test for prostate cancer is through a PSA (Prostate Specific Antigen) blood test, this can be followed or supplemented by a rectal exam. For prostate cancer to be diagnosed doctors must perform a biopsy of the prostate. PSA screening has become increasingly common, however this increase in screening has come with some disagreement within the medical community. PSA screening can act like a large net catching all types of prostate cancer, even those that may not be immediately threatening to the patient. This can cause patients without a clinical need to undergo further, more invasive, screening like a prostate biopsy. This can expose the patient to considerable anxiety, discomfort, and unnecessary risk. A wealth of data is lacking for the benefits of widespread PSA screening, however since PSA screening became more common there has been a decrease in deaths from prostate cancer. Men should consider asking their doctor about PSA screening when they are between the ages of 50 and 65. Deciding whether or not screening is right for an individual patient, and at what interval that patient should be screened, involves a conversation with their doctor. Recommendations are based on surveys and outcomes from large population data, but for the patient and their physician it is a personal decision.

There are a lot of different opinions that exist in the medical community about how to prevent prostate cancer. There is some evidence that being more sexually active can help prevent prostate cancer. However, the most widely accepted prevention for prostate cancer, and any cancer for that matter, is through a healthy lifestyle. Dr. Deholl explains “if you took a book called ‘how to keep your heart healthy,’ you could rip the cover off and write ‘how to keep your prostate healthy.’” This means maintaining a physically active lifestyle, eating healthy, not smoking, and reducing alcohol intake. No two prostate cancers are exactly alike, and it is important that every man takes the steps to stay healthy and have regular conversations with their physicians about their prostate health.

In order to jump start prostate health awareness in our community, Pardee is offering free prostate screenings this fall, which will include a PSA test and a rectal exam. This will be done in collaboration with Pardee Cancer Center, which is a resource for prostate cancer patients in the Western North Carolina area. The development of the cancer center has given prostate cancer patients the freedom to receive outstanding care within their community from a team of exemplary physicians.

Check back with us soon for more details about the cancer screenings this September. To discuss concerns about your prostate health immediately, contact Dr. Deholl, Donaldson, or Little at Pardee Urological Associates in Hendersonville. You can schedule an appointment at (828) 692-6262.

Additional sources: https://www.cancer.org/cancer/prostate-cancer/about/key-statistics.html

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