By Al Borhan, M.D.

    Prostate cancer, the most common non-skin malignancy affecting men in the United States, is the second-leading cause of cancer death in men, according to the American Cancer Society. One in six men will be diagnosed with prostate cancer in his lifetime.

    Although potentially life-threatening, such cancers often are curable. Prostate cancer is most treatable when caught early. That’s why the American Urological Association strongly supports early prostate cancer detection and feels it is in a man’s best interest to be tested for prostate cancer.

 

The AUA recommends digital rectal exams and prostate-specific antigen (PSA) testing for early detection and risk assessment for all men aged 40 and older.

PSA, a tumor marker concentrated in prostate tissue, is used for early detection: serum PSA levels are normally very low, but prostate disease usually leads to the production of greater amounts of PSA. The future risk of prostate cancer is closely related to a man’s PSA score. Screening at 40 establishes a baseline that can be tracked over time.

    Over the past decade, since PSA testing has become widespread, deaths from prostate cancer have decreased by 40 percent. The percentage of patients whose prostate cancer has spread has dropped from 21 to 4 percent.

    In many patients, prostate cancer progresses slowly, resulting in tumors that remain localized to the prostate gland. In others, tumor growth may be more rapid and cancer may spread.

    Strategies for managing prostate cancer have therefore been aimed at early detection, with selective, tailored treatment. The AUA strongly supports informed consent, including a discussion about the benefits and risks of testing, before screening is undertaken. The AUA further recommends that certain men newly diagnosed with prostate cancer be given the option of active surveillance in lieu of immediate treatment.

    In addition to PSA scores and physical exams, the decision to proceed to prostate biopsy should also consider patient age, family history, ethnicity, prior biopsy history and co-morbidities.

    A cancer cannot be treated if it is not detected. The combination of the digital rectal exam and the PSA test provides important information in the diagnosis, risk assessment and monitoring, allowing millions of men to make informed treatment decisions that may save their lives.

 

Al Borhan, M.D., a board certified urological surgeon and a recognized authority on prostate cancer,  is co-director of Robotic Surgery at John C. Lincoln Hospitals and welcomes patients at 9100 N. 2nd St., Suite #213, telephone 602-264-0608.. The information in “To Your Health” is provided by the John C. Lincoln Healthcare Network as general information only. For medical advice, consult your physician.