June is Men’s Health/Cancer Awareness Month, and the week of June 7 to June 13 is National Men’s Health week. At the Cancer Care Institute, we want to educate men in our community about the most common cancer that afflicts them – prostate cancer.
About Prostate Cancer
Prostate cancer occurs in a man’s prostate. The prostate gland is a small walnut-sized gland. It makes the seminal fluid that surrounds a man’s sperm for nourishment and transport. Most types of prostate cancer are slow-growing, and in its early stages stays in the prostate gland. Slow growing prostate cancer may need no treatment or minimal treatment. Unfortunately, as with other cancers that attack other parts of the body, some prostate cancers are aggressive, spread quickly and need immediate treatment. But, according to the Centers for Disease Control and Prevention, many men pass away from other causes and never knew they had prostate cancer – some in their eighties or nineties.
Men over 50 are most at risk for some type of prostate cancer – especially
- African-Americans;
- Men who have a father or brother with prostate cancer; and
- Men who eat a diet containing fatty foods
Symptoms of Prostate Cancer
During the early stages of prostate cancer many men don’t have symptoms. As the cancer grows, later symptoms may occur and include
- Urinating often, especially at night;
- Problems starting or ending urination;
- A weak urinary stream, or a stream that is interrupted;
- Pain or burning feeling during ejaculation or urination;
- Blood in urine or semen; and
- Pain in hips, thighs or the lower back.
Common complications of prostate cancer include,
- Cancer that metastasize (spreads)
- Erectile dysfunction
- Incontinence
Diagnostic Tests for Prostate Cancer
When men have no symptoms, doctors have two tests for prostate cancer screening. They are
- The PSA test – this is a simple blood test to detect a substance made by the prostate called “prostate-specific antigen” (PSA).
- The digital rectal exam – in this test, doctors use a sterile lubricated glove to feel the prostate. The doctor is looking for lumps or hard areas called nodules.
Used together these tests can suggest the presence of prostate cancer. It is important to know that without a microscopic examination, there is definitive diagnosis. Some men without cancer may have higher levels of PSA while men with normal PSA levels may have cancer. The digital exam is also limited as physicians can only feel the back of the gland.
Confirming a diagnosis of prostate cancer requires that your prostate cells undergo a microscopic exam. Doing this means a trip to your urologist’s office where he or she takes a small tissue sample for evaluation and testing under a microscope.
Should the evaluation of the tissue show you have prostate cancer, the next step is go grade your cancer. This is done by the pathologist who first examined your tissue. Usually, the Gleason Score is the way the pathologist scores your cancer. The scores range from 2 – non-aggressive cancer to 10 – very aggressive cancer. When your physician suspects your cancer has spread, imaging tests usually are the next step. These include
- Computerized tomography (CT) scan
- Bone scan
- Magnetic resonance imaging (MRI)
- Positron emission tomography (PET)
- Ultrasound
Treatment
There a number of treatment modalities used in treating prostate cancer – each has certain advantages and certain risks. Doctors personalize your treatment based on the stage of cancer you have. Often, men with non-aggressive prostate cancer have no symptoms and the best treatment for them is ‘wait and watch.” For men with more aggressive cancers options include surgery, medication, and radiation therapy.
June is men’s health month, and the 7th to the 13th is Men’s Health Week. Talk with your doctor about whether you need screening and follow his or her advice. Do it now, so you can enjoy the rest of the summer!
Dr. Do is a graduate of the University of California, Irvine College of Medicine and trained in Radiation Oncology at University of California Irvine City of Hope and Long Beach Memorial. Prior to joining the Cancer Care Institute, Dr. Do was an assistant professor at the University of California, Davis in Radiation Oncology. Dr. Do has presented and lectured at many national and international conferences on brachytherapy, radiosurgery and comparative clinical outcome.
