Health care professionals are ramping up their efforts to talk to men about the disease because September is National Prostate Cancer Awareness month.
Catching cancer in its early stages is the most important part of treating it, said general physician Jeffrey Tharp. Prostate cancer is common among men older than 55, and it forms in the tissues of the prostate, which is a gland in the male reproductive system.
“Prostate cancer is an invasive cancer of the prostate gland that affects mostly older men,” Tharp said.
There are two ways to be tested for the presence of prostate cancer, Tharp said. One is a blood test and another is a digital rectum test.
The blood test measures the levels of prostate specific antigens produced by the gland. Tharp said a prostate always produces PSAs, but cancerous cells produce more than healthy prostate cells.
Tharp said controversy has surrounded the blood test because doctors have questioned the accuracy of using a PSA level to decide if a man tests positive for prostate cancer.
“The controversy (about the test) is whether the PSA is a good measure because of its accuracy problems,” he said.
Tharp said other things can increase PSA levels, so sometimes blood tests are inaccurate.
“If a PSA is elevated, it can be coming from several different reasons — it can be from prostate cancer, it can be increased because of age, an enlarged prostate or an infection,” Tharp said.
Tharp said about 12 percent of PSA tests are inaccurate, meaning people tested positive for cancer but have non-cancerous prostates.
Other symptoms of prostate cancer are difficulty urinating or frequent urination, Tharp said.
“Advanced cancer can show up with bone pain and weight loss if it’s spread beyond the prostate,” Tharp said.
When patients show high PSA levels, they are sent to an urologist, who takes a biopsy to test for cancer, said Justin Hart, a radiation oncologist at Kennestone Hospital.
Hart said once a doctor and patient decide the risk is high enough, there are three common ways to treat the disease.
“For patients who have a low-risk disease or who have 10 years or less of life expectancy, there’s the active surveillance treatment where we monitor their PSA, do physical exams and possibly more biopsies,” Hart said. “But, we don’t do any treatment.”
Many patients treat the cancer by removing the prostate gland. The process can be done by a robot, which Hart said makes more precise incisions.
Another option is radiation treatment, Hart said, which can be done by lying in a machine that emits radiation into the prostate or by injecting radiation seeds into the prostate that emit radiation from the inside.
“Radiation is very effective at killing cancer cells,” Hart said.
Patients usually undergo radiation treatment five days a week for seven weeks, Hart said.
Hart said a new treatment is available at WellStar locations for patients who have an advanced stage of the cancer that has spread to the bones.
“It’s a radiation that you inject into the patient’s blood. It’s called Xofigo, and it’s very successful at helping patients who have the cancer in their bones and helping pain,” Hart said.
Patients who choose to take the medication need injections every month for six months, Hart said.
Tharp said about 9 percent of men who die from cancer die of prostate cancer. He added men who have prostate cancer often die of other causes because the disease is common in older men.
“Prostate cancer is a very slow cancer — slow to elevate and slow to spread,” Tharp said.
Tharp said doctors have been able to catch the cancer at its early stages more often in recent years because of awareness.
“Because of increased PSA testing in the past 25 years, we have been able to diagnose it earlier,” Tharp said. “People who have high risks, they need to start thinking about having the conversation with their doctor earlier.”
Those at high risk for the disease include men older than 55, men born in North America and the Caribbean, African-American men and men who are obese or eat a diet high in fat, Tharp said.
WHAT IS IT?
“Prostate cancer is an invasive cancer of the prostate gland that affects mostly older men, ages 55 and older.”
THOSE AT RISK
People at high risk for prostate cancer:
● People who have a history of the cancer in their family
● African Americans
● People born in North America and the Caribbean
● People who are obese or eat foods high in fat
♦Two ways to be tested for prostate cancer: prostate specific antigen (PSA) blood test or digital rectal exam; Tharp recommends men get both
♦Talk to your doctor to identify the risks and benefits of being tested at about age 55
HREE TREATMENT OPTIONS
♦Surgery to remove prostate
♦9 percent of all men who die of cancer die of prostate cancer
♦93 percent of prostate cancers are diagnosed at the local or regional stages, for which 5-year survival approaches 100 percent
MORE GENERAL RATES
♦Incidences in the U.S.: 151.4 per 100,000 men
♦Incidences in Georgia: 167.8 per 100,000 men
♦Death rates in the U.S.: 23.6 per 100,000 men
♦Death rates in Georgia: 27.5 per 100,000 men
* Source: Dr. Jeffrey Tharp/American Cancer Society, Facts and Figures 2013, www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-036845.pdf