Prostate Cancer Awareness: What You Should Know

Here’s a little public service announcement about prostate cancer. It’s important.

Prostate cancer stands as the most frequently diagnosed cancer among men in the U.S., excluding skin cancer, and it ranks as the second leading cause of cancer-related deaths among men, following lung cancer.

Statistics show that one in six men will be diagnosed with prostate cancer, with approximately 3% succumbing to the disease.

The early stages of prostate cancer often don’t present any noticeable signs because the tumors tend to be small and localized. This is where PSA testing comes into play—it can help identify potential issues before any symptoms arise.

September is dedicated to Prostate Cancer Awareness Month. Here are some vital updates concerning screening guidelines, treatment advancements, and a dietary tip that might aid in prevention:

Understanding the Risk Factors

Prostate cancer arises from the uncontrolled growth of abnormal cells in the prostate, a small gland located below the bladder and in front of the rectum.

When these cells begin to spread beyond the prostate, it poses significant health concerns.

I’m not entirely sure what causes prostate cancer, but I do understand there are genetic factors involved.

If a first-degree relative like your father or brother has had it, your risk increases. Furthermore, African American men are at a notably higher risk compared to other racial groups, though the reasons remain somewhat unclear.

Age is also a significant factor; the likelihood of developing prostate cancer tends to rise as men get older.

Recognizing the Symptoms

Interestingly, if the prostate cancer is curable, it often has no symptoms. Therefore, screening is crucial for detecting this disease early.

As the cancer progresses, the prostate can grow and press against the bladder and urethra, leading to urinary difficulties. When it spreads, it often targets the bones, which can cause pain, numbness, or even neurological issues.

In more advanced cases, it may affect other organs, potentially leading to fatal outcomes.

Diagnosis of Prostate Cancer

Regular PSA screenings are recommended for men starting at age 50. However, African American men and those with a family history of prostate cancer should consider beginning screenings around age 45.

This simple blood test is usually part of annual physical exams. If your doctor finds concerning PSA levels, you might be referred to a urologist for further tests, like an MRI or a biopsy. Typically, most diagnoses occur in men in their mid-60s.

The U.S. Preventive Services Task Force advises against routine PSA screening for men over 70, as the potential benefits may not outweigh the risks.

This guidance was put into place over a decade ago and reaffirmed in 2018. A notable issue is that PSA is “prostate-specific” but not necessarily indicative of cancer, as other factors can elevate PSA levels, including benign conditions.

In the past, many men underwent unnecessary biopsies, with some diagnosed with low-risk diseases that didn’t require immediate intervention. In the 1990s, widespread PSA screening led to more diagnoses but also to an increase in aggressive cancer cases among older men.

Men over 70 are encouraged to discuss with their doctors whether screening is appropriate for them.

NYU Langone suggests screening for men with a life expectancy of at least 10 years, irrespective of their age.

Preventing Prostate Cancer

One group of drugs, known as 5 Alpha reductase inhibitors, is prescribed to treat enlarged non-cancerous prostates. Some researchers have proposed they could also prevent prostate cancer, but there are concerns about heightened risk for aggressive cancer types. While this concept hasn’t been fully validated, these drugs aren’t marketed as preventive measures.

I think a key focus should be on maintaining a healthy lifestyle through regular exercise and an appropriate diet.

There’s some debate regarding the effectiveness of a vegan diet in preventing prostate cancer. However, there’s evidence suggesting that reducing lean meat and processed sugars might be beneficial.

Treatment Options for Prostate Cancer

Treatment strategies for prostate cancer depend on the cancer’s location, aggressiveness, and whether it has spread.

For low-risk cancers, careful monitoring is often recommended, but unfortunately, many patients delay necessary treatment.

If cancer spreads significantly, radical prostatectomy can involve removing the entire prostate, or radiation therapy may be employed to target cancer cells.

A downside to radical surgery can be urinary issues and sexual dysfunction, while radiation generally poses less risk for incontinence but can lead to other complications.

In certain cases, the cancer may be too aggressive to monitor yet not aggressive enough to warrant complete surgical removal or radiation.

At NYU Langone, we’ve introduced innovative treatments, such as local therapy that identifies and freezes the aggressive areas of the gland. This outpatient procedure has shown promising results.

In my experience with about 600 men, the assessments of treatment quality, complications, and outcomes through cryotherapy have been very promising, and we’re preparing to publish further data from this seven-year study.

This approach avoids many surgery-related complications, like incontinence or rectal issues, and has significantly reduced disturbances in sexual function.

Ultimately, recurrence risks depend heavily on the cancer’s initial aggressiveness.

All these factors and considerations are thoroughly discussed with patients to find the best treatment plan.

Looking Forward

We’ve made remarkable progress in PSA screening, MRI-guided biopsies, and advanced treatment options like local therapy over the past two decades.

However, there’s still much work to be done. We need improved screening methods to help distinguish which cancers necessitate treatment versus those that can be safely monitored.

Moreover, finding better treatments for metastatic disease is crucial. Despite our advancements, many still lose their lives to prostate cancer.

Here at NYU Langone, alongside other leading health institutions globally, we are devoted to transforming prostate cancer into a more manageable, curable challenge for all men.