You don’t hear about prostate cancer much. It isn’t like breast cancer, which seems to turn the entire month of October pink. No one seems to be racing for a cure. Did you know September is Prostate Cancer Awareness Month? It is.
Prostate cancer is confusing. It is estimated that 80 percent of all men will be diagnosed with prostate cancer – if they live long enough, it is almost a guarantee – yet there is great debate among doctors as to whether men should be routinely screened. It tends to be a slow growing type of cancer, and, even if you have prostate cancer, chances are you’ll die first from another cause. But, like any other cancer, it can grow and become invasive, metastasizing to other parts of the body where it is likely to become a real challenge.
The prostate, which is underneath the bladder, looks sort of like a walnut. It has a tendency to become larger as men age and, because of its location, can start to cause a little trouble, such as having to urinate more often, especially at night.
Most men with early prostate cancer have no symptoms. In later stages, men may experience blood in the urine or erectile dysfunction. More urgent symptoms indicating likely metastasis can include pain in areas such as the spine, the hips or the chest or loss of control of the bowels or bladder.
Is There a Test for Prostate Cancer?
Most cases of prostate cancer are identified by the PSA test. PSA is a protein produced in the prostate gland that can be measured by a blood test. Although men with prostate cancer have higher PSA levels, a high PSA does not necessarily indicate that cancer is present. But if that number is high, most urologists will suggest further testing, including a DRE (digital rectal exam) and possibly an ultrasound or an MRI. A biopsy may be suggested so that a pathologist can determine the presence of a tumor.
The Urologist Diagnosed Cancer. Now what?
Depending on the type of prostate cancer and its stage, your doctor may recommend “watchful waiting.” If it stays within the prostate, doesn’t cause difficulty and grows at a very slow rate, you may need no treatment at all, avoiding possible side effects of surgery or medications.
Like any cancer, it is classified as stage I, II, III or IV. Signs that the cancer may have spread beyond the prostate include a high PSA number, a high Gleason score (scores range from 2 to 10 and are determined by microscopic study; the lower the number, the better) or bone pain. A variety of tests, such as a bone scan, may be done in addition to CT scans or MRIs to provide detailed images.
“The key indications for treatment are the Gleason score, the PSA test and the stage,” said Dr. Louise Clay, a radiation oncologist with Roper St. Francis.
In addition to “watchful waiting” for stage I cancers, more aggressive treatments include prostatectomy, external beam radiation, hormone therapy, brachytherapy or hormone therapy, with or without radiation. Side effects of treatment can affect the bladder, rectum and urethra, particularly in more advanced cancers.
But what really excites Dr. Clay is CyberKnife.
“Our newest treatment is CyberKnife for low and low to intermediate grade patients, a very intense course of radiation over a short time, about five treatments over the course of two weeks,” Dr. Clay explained.
What is CyberKnife Therapy?
This is a non-invasive treatment which is extremely accurate in pinpointing only the prostate with high doses of radiation, sparing nearby healthy tissue. Two technologies have been blended together to treat tumors that were unreachable in the past: an image-guidance system to locate and track the tumor and a maneuverable robotic arm.
Unlike surgery, CyberKnife is painless, non-invasive and lasts only about 30 to 90 minutes. And patients are able to resume daily activities afterward. Roper St. Francis is currently the only hospital in the area to offer CyberKnife therapy.
How Can I Prevent Prostate Cancer?
There are no known preventive methods, but the best advice is to live a healthy lifestyle with a diet low in fat, include plenty of fruits and vegetables, add fish and reduce your dairy intake. Maintaining a healthy weight and regular exercise are always good ideas. And if you have a family history of prostate cancer, discuss that with your doctor. Knowledge is power.
And, by the way, there is a cancer awareness and fundraising event which takes place in September. Roper St. Francis Cancer Care holds the annual Burger Prostate Challenge Golf Tournament, named for writer Ken Burger, who underwent treatment in 2008.