September is Prostate Cancer Awareness Month. But why is this annual observation needed? Men and the people who care about them should know that prostate cancer is the most common cause of cancer death among American males. They should also know that it can be detected and treated.
Prostate cancer will kill an estimated 30,000 men in the US and 250,000 worldwide in 2012 alone. Over the past 20 years the incidence of prostate cancer has gradually increased and now affects one in every six America men. Yes, there are more cases of the disease but fewer men are dying from it − the mortality rate has decreased by 40 percent in the past decade.
The Prostate Cancer Foundation and the American Urology Association (AUA) believe that detection through what is called prostate specific antigen (PSA) screening is responsible for saving many of those lives, and I agree.
There is some controversy regarding PSA screening − and no science is perfect − but there is a significant amount of evidence to support the validity of the test.
What do we know?
- Prior to PSA screening, 25 percent of patients with newly diagnosed prostate cancer already had spread of the cancer and were not curable;
- Today with PSA screening, only 4percent of men diagnosed with prostate cancer have spread of the cancer at the time of diagnosis;
- In Great Britain where PSA screening is not utilized, 50 percent of men diagnosed with prostate cancer will survive 5 years;
- In the US, with PSA screening, 90 percent of men survive 10 years;
- In a study performed at Roper Hospital the amount of patients who underwent surgery to remove a cancerous prostate in the pre-PSA years had a 25% probability of local spread of the cancer. Today with PSA screening the number of men who have local spread of cancer at the time of surgery is less than five percent;
- With PSA screening we are able to improve the survival rate of patients with prostate cancer and avoid unnecessary treatment in some patients with very early stage prostate cancer;
- The men who are at highest risk for developing prostate cancer should be followed very closely. This group includes African Americans and men with a family history of prostate cancer. Can prostate cancer be prevented? Not totally, but there are factors that can decrease the probability of developing it. Genetics play an important role, but what are some controllable factors?
- Obesity. Obese men have an increased risk of prostate cancer, colon cancer, breast cancer, diabetes and heart disease;
- Exercise. It lowers the risk of prostate cancer and improves erectile function. The combination of increased body fat and lack of exercise increases the probability for aggressive prostate cancer;
- Diet. Whole grains, fruits, vegetables and reducing animal fat intake decrease the risk of prostate cancer.
When should men get tested?
The AUA says to get the first PSA screening at age 40, the second at 45 and the third at 50. If levels are still healthy, the AUA recommends repeating the test annually until age 75.
Get screened for free at one of four Roper St. Francis locations on Sept. 13 and attend a Men’s Health Night aboard the USS Yorktown Sept. 27 to learn more about your health. Both free events require registration by calling 402-CARE.
By William C. Carter, MD, a board certified urologist with Lowcountry Urology Clinics