Prostate Cancer Awareness Month

September is Prostate Cancer Awareness Month and we encourage you to learn more!

How common is prostate cancer?

Prostate cancer is the most common non-skin cancer in America, affecting 1 in 7 men.

In 2014, approximately 233,000 men will be diagnosed with prostate cancer, and more than 29,000 men will die from the disease. One new case occurs every 2.3 minutes and a man dies from prostate cancer every 18 minutes in the United States.

However, when detected early through routine physical exams and blood tests, prostate cancer is effectively curable.

How does prostate cancer compare with other cancers?

A non-smoking man is more likely to develop prostate cancer than he is to develop colon, bladder, melanoma, lymphoma and kidney cancers combined. In fact, a man is 35% more likely to be diagnosed with prostate cancer than a woman is to be diagnosed with breast cancer.

Are some men more likely to be diagnosed with prostate cancer?

As men get older, there is increased risk of developing prostate cancer.  Although only 1 in 10,000 under age 40 will be diagnosed, the rate shoots up to 1 in 38 for ages 40 to 59, and 1 in 14 for ages 60 to 69. About 60% of all prostate cancers are diagnosed in men over the age of 65 and 97% occur in men 50 years of age and older.

A family history of prostate cancer (one’s brother or father had prostate cancer) increases one’s risk of developing prostate cancer.  The risk is highest if one’s family member developed prostate cancer before age 65.

African American men are 56% more likely to develop prostate cancer compared with Caucasian men and nearly 2.5 times as likely to die from the disease.

A high cholesterol and high fat diet, obesity and a sedentary lifestyle also increase the risk of developing prostate cancer.

What are the screening tests for prostate cancer?

There are 2 main screening tests for prostate cancer:

The first is the PSA test is a blood test.

The second is the digital rectal exam (DRE).  Here a doctor inserts a gloved, lubricated finger into the rectum to feel for any bumps or hard areas on the prostate that may need to be tested for cancer. This is a very quick exam.

Screening is most effective when both the PSA blood test and digital rectal exam are done.

What if the results are not normal?

If the results of the PSA and/or DRE suggest that you might have prostate cancer, your doctor will do a prostate biopsy.  At Somerset Urological, we offer these biopsies under intravenous sedation so it is painless!  With a biopsy, samples of prostate tissue  are removed using a needle and sent to a lab, where a specialist will look at it under a microscope to see if it contains cancer cells.

At what age should men have their first screening test?

Men at average risk of prostate cancer should be screened starting at age 50.  Men at higher risk (family history, African American) should have screening starting at age 50.

How curable is prostate cancer?

As with all cancers, “cure” rates for prostate cancer describe the percentage of patients likely remaining disease-free for a specific time period.  In general, the earlier the cancer is caught, the more likely it is for the patient to remain disease-free.

Because approximately 90% of all prostate cancers are detected in the local and regional states, the cure rate for prostate cancer is very high – 90%-100% of men diagnosed at this stage will be disease-free after five years.  By contrast, in the 1980’s when the PSA blood test was not available, only 67% of men diagnosed with local or regional prostate cancer were disease-free after five years.

What are the symptoms of prostate cancer?

If the cancer is caught at its earliest stages, most men will not experience any symptoms. That is why prostate cancer screening is so important.  If a man waits until he has symptoms, it is often too late.  So the key is to get screened for prostate cancer with the easy and quick PSA blood test and digital rectal exam.

How is prostate cancer treated?

There are a wide variety of treatment options available for men with prostate cancer, including surgery, radiation therapy, hormone therapy and chemotherapy, any or all of which might be used at different times depending on the stage of disease and the need for treatment.

At RWJ Somerset, we are fortunate to have the Prostate Cancer Institute in which all of the urologists at Somerset Urological are active participants with Dr. Joel Fischer serving as the Chairman of the Prostate Cancer Institute.  At these meetings, our urologists review individual patient’s cases with medical oncologists and radiation oncologists to devise the best treatment plan for that individual.

When Somerset Urological urologists discuss prostate cancer treatment options with our patients, we identify the optimal treatment after balancing the risks posed by the cancer versus the potential risks posed by the treatment.

For men diagnosed with a higher volume of cancer or more aggressive grades, treatment is recommended such as surgery to remove the prostate (radical prostatectomy) or radiation therapy (either in the form of state of the art external radiation , seed implantation, or both together).  Some patients prefer to quickly remove the cancer which makes surgery more appealing, while others prefer to avoid any operation and proceed with radiation therapy.  There are no wrong choices, which makes the decision very difficult.

Somerset Urological’s Dr. Dhiren Dave has mastered the minimally invasive robotic approach to radical prostatectomy using the DaVinci system.  Patients go home from the hospital the day after the surgery with minimal discomfort.

Conversely, some prostate cancers pose relatively low risk to the patient, and don’t truly threaten the patient’s quality or quantity of life.  In these cases, the patient would not benefit from treating the cancer.  With these patients, an “active surveillance” approach is best.  With this approach a patient is carefully monitored with repeat PSA blood tests and prostate exams every 6 months.  A prostate biopsy may be repeated every 12-18 months.  At Somerset Urological, we use innovative tests, such as the multiparametric MRI scan of the prostate, to appropriately select the right patient for this active surveillance approach.