“Prostate cancer will kill more than 27,500 of our Nation’s fathers, husbands, sons, and brothers … and more than 220,000 Americans will be diagnosed…in 2015 alone.” Thus begins the Presidential Proclamation that September 2015 is National Prostate Cancer Awareness Month. But dire statistics aren’t the whole story. The American Cancer Society states, there are “more than 2.9 million men in the United States who have been diagnosed with prostate cancer at some point [and] are still alive today [emphasis added].”
The “lifetime risk of dying from prostate cancer is 3%” meaning that most men with a prostate cancer diagnosis will die of something else. Why?
Most prostate cancers take 10 to 30 years to get big enough to cause symptoms. Around 60% of prostate cancer cases are found in men age 65 and over. Since the average man reaching 65 today can expect to live until age 84.3, the odds of dying from prostate cancer are reduced.
Another reason is the Prostate-Specific Antigen test (PSA). This diagnostic blood test is highly sensitive, detecting very small tumors, even those that are not causing symptoms.
Even so, the PSA is part of recommended screening, with a digital rectal exam (DRE), that starts at age 50 up to age 75. For African American men and men with family history (father, brother, son) of prostate cancer, screening begins at 45.
Sensitivity increases false positives. Elevated PSA can be caused by non-life threatening conditions like benign prostatic hyperplasia (an enlarged prostate), prostatitis (an infection of the prostate), or even a recent ejaculation. Urologists are the physician specialists to consult about biopsy after an elevated PSA.
For A Positive Biopsy
Your urologist reviews the Gleason Score (a cell categorizing tool) of your biopsied tissue. If the cells in the tissue look a lot like normal prostate cells, the score will be low. A high score means that the cells don’t look at all like normal cells and indicates that the cancer is aggressive. According to Dr. Steven Kaplan, Professor of Urology at Weill Cornell Medical College, most Gleason Score’s for cancers range from 6 to 10.
Treatment for Low Risk Prostate Cancer
Treatment depends on the stage that the prostate cancer is found. With PSA screening, most prostate cancers that are found are localized low risk prostate cancers, defined as “A Gleason score of 6 or less, PSA less than 10 mg/ml, and a tumor that is either non-palpable [cannot be felt] or only palpable in less than half of one lobe of the prostate.”
The three treatment options for localized low risk prostate cancer are surgery, radiation or active surveillance.
Reducing Your Risk of Prostate Problems
Though no proven prevention strategy exists for forestall prostate problems, the Mayo Clinic recommends exercise and choosing a healthy diet to reduce risk. Remember, if you experience reduced urine output or increased frequency, consult a urologist, and get checked.
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