By Sharon Gordon
Johannesburg - Millions of people across the world suffer from prostate cancer but early detection can save lives. While cancer awareness month has just passed, it is still important to get your prostate medically checked as soon as possible.
What Is Prostate Cancer Screening?
Cancer screening means looking for cancer before it causes symptoms. The goal of screening for prostate cancer is to find cancer early that may spread if not treated.
There is no standard test to screen for prostate cancer. Two tests that are commonly used to screen for prostate cancer are—
A blood test called a prostate specific antigen (PSA) test. PSA is a substance your prostate makes. This test measures the level of PSA in your blood. Your PSA level may be high if you have prostate cancer and for many other reasons, such as having an enlarged prostate, a prostate infection, or taking certain medicines.
Digital rectal examination, when a health care provider inserts a gloved, lubricated finger into a man’s rectum to feel the prostate for anything abnormal, such as cancer.
What Are the Symptoms of Prostate Cancer?
If you have any symptoms that worry you, be sure to see your doctor right away. They may be caused by conditions other than prostate cancer.
Different people have different symptoms for prostate cancer. Some men do not have symptoms at all.
If you have any of the following symptoms, be sure to see your doctor right away:
Difficulty starting urination.
Weak or interrupted flow of urine.
Frequent urination, especially at night.
Difficulty emptying the bladder completely.
Pain or burning during urination.
Blood in the urine or semen.
Pain in the back, hips, or pelvis that doesn’t go away.
Painful ejaculation.
Keep in mind that these symptoms may be caused by conditions other than prostate cancer.
Different types of treatment are available for prostate cancer. You and your doctor will decide which treatment is right for you.
Some common treatments are:
Expectant management. If your doctor thinks your prostate cancer is unlikely to grow quickly, he or she may recommend that you don’t treat the cancer right away. Instead, you can choose to wait and see if you get symptoms in one of two ways:
Active surveillance. Closely monitoring the prostate cancer by performing prostate specific antigen (PSA) tests and prostate biopsies regularly, and treating the cancer only if it grows or causes symptoms.
Watchful waiting. No tests are done. Your doctor treats any symptoms when they develop. This is usually recommended for men who are expected to live for 10 more years or less.
Surgery. A prostatectomy is an operation where doctors remove the prostate. Radical prostatectomy removes the prostate as well as the surrounding tissue.
Radiation therapy. Using high-energy rays (similar to X-rays) to kill the cancer. There are two types of radiation therapy—
External radiation therapy. A machine outside the body directs radiation at the cancer cells.
Internal radiation therapy (brachytherapy). Radioactive seeds or pellets are surgically placed into or near the cancer to destroy the cancer cells.
Other therapies used in the treatment of prostate cancer that are still under investigation include:
Cryotherapy. Placing a special probe inside or near the prostate cancer to freeze and kill the cancer cells.
Chemotherapy. Using special drugs to shrink or kill the cancer. The drugs can be pills you take or medicines given through your veins, or, sometimes, both.
Biological therapy. Works with your body’s immune system to help it fight cancer or to control side effects from other cancer treatments. Side effects are how your body reacts to drugs or other treatments.
High-intensity focused ultrasound. This therapy directs high-energy sound waves (ultrasound) at the cancer to kill cancer cells.
Hormone therapy. Blocks cancer cells from getting the hormones they need to grow.
If diagnosed early, many prostate cancers grow slowly and don’t cause any health problems in men who have them.
If you decide not to get screened, you can always change your mind later. If you decide to get screened, it does not mean you have to go to the next step. You should discuss each step with your doctor.
Most prostate cancers found by screening are small and slow growing and may not be fatal. Some men may have a faster growing prostate cancer and will benefit from early treatment.
Older men, African-American men, and men who have a family history of prostate cancer have a greater risk for developing prostate cancer. If you are concerned that you may have a greater risk for prostate cancer, talk to your doctor about screening.
Screening for prostate cancer
One screening test for prostate cancer is a prostate-specific antigen (PSA) blood test, which can be abnormal (not normal) for several reasons besides prostate cancer.
The only way to know if an abnormal test is due to cancer is to do a biopsy. A biopsy is a surgery to get small pieces of the prostate to look at under a microscope. If the biopsy shows there are cancer cells, then your doctor will discuss treatment options.
Treatment of prostate cancer may include:
Close monitoring and follow-up visits.
Radiation.
Surgery to remove the prostate.
Side effects from radiation or surgery may include:
Impotence.
Loss of bladder control.
Problems with your rectum.
Risk factors for prostate cancer:
The best known and proven risk factors for prostate cancer are advancing age, race and a positive family history of prostate cancer.
There are other risk factors but there is less evidence for these:
Age
As men get older they are more likely to get prostate cancer. The risk for prostate cancer begins to rise sharply after age 55 years and peaks at age 70–74. Global statistics show that three quarters of prostate cancer occur in men over the age of 65 and that prostate cancer is rare in men below the age of 50. However it is important to note that black African men tend to get prostate cancer at a younger age.
Race
In the USA the risk of prostate cancer is 60% higher in black American men compared to white males. The risk of dying of prostate cancer amongst Black African American men is also twice as high as that of white American men. The current statistics in South Africa are unreliable for a number of reasons but based on the studies from the USA and the UK we believe that black African men are at a much higher risk of getting prostate cancer than other race groups. The type of prostate cancer that they get is also likely to be more aggressive and to be passed on genetically.
Family history
There is strong evidence to show that a family history of prostate cancer increases a man’s risk of prostate cancer. Men who have a father or brother with prostate cancer are 2 to 3 times more likely to get prostate cancer themselves. The number of relatives with prostate cancer and their age at diagnosis is also important in terms of the likelihood of being affected at a younger age. Some studies show that having a mother or daughter who has had breast cancer also increases a man’s risk for prostate cancer.