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Tests determining if prostate cancer has metastasized

No man or his loved ones like to think of the possibility of his prostate cancer spreading beyond this gland.  But, prostate cancer, like all cancers, has the potential to spread or metastasize to other parts of the body.  If and when it does, it will typically affect the structures within the immediate area such as your seminal vesicles, urinary bladder, and bones of your pelvis.  Other likely areas prostate cancer may spread to are the bones or lymph nodes near the prostate and other organs such as the liver and intestines.

How would a man know if his prostate cancer has spread?

The spread of prostate cancer may be suspected if there are certain symptoms.  If a man is experiencing lower back pain this could indicate his prostate cancer may have metastasized to the lower spine.  Other ways to know if prostate cancer has spread beyond the prostate gland is if a man’s liver enzymes are elevated or if his prostate specific antigen (PSA) levels are continuing to rise despite treatment.

Tests doctors use to find and detect metastatic prostate cancer

There are several tests a doctor can utilize to help determine and detect metastatic prostate cancer which include the following:

·      Bone scan

A bone scan is a specialized nuclear imaging procedure used to examine the various bones of the skeleton.  It uses tiny amounts of radioactive materials called radionuclide or tracers used to assist in the examination of the bones.  The radionuclide or tracers will collect within the bone tissue at spots of abnormal physical and chemical change. 

The areas where the radionuclide collect are called “hot spots” indicating the presence of conditions such as metastatic bone cancer. 

·      CT scan

A CT scan can be useful when a doctor thinks cancer might have spread but doesn’t know where to.  Computerized tomography or CT scan is a combined series of x-ray images taken from different angles using computer processing to create cross-sectional images of slices, of the bones, blood vessels and soft tissues inside the body.  A CT scan will provide more information than an x-ray will.

A CT scan can be used to diagnose disease or injury and can show spread of cancer to the liver, bones, adrenal glands or some other organs. 

·      MRI

MRI stands for magnetic resonance imaging which uses magnetism and radio waves to build up a picture of the inside of the body.  It can be used to show how deeply a tumor has grown into body tissues playing an important role in cancer diagnosis, staging, and treatment planning.  An MRI will provide a greater contrast within the soft tissues of the body than a CT scan and it is often used for imaging of the brain, spine, muscle, connective tissue and the inside of bones.

·      PET scan

Positron emission tomography (PET) scan is a nuclear imaging technique that creates detailed, computerized pictures of organs and tissues inside the body.  PET scans can reveal how the body is functioning and helps uncover areas of abnormal metabolic activity.

In this procedure a person is injected with a glucose (sugar) solution containing a very small amount of radioactive material – cancer cells often use more glucose than normal cells.  Cells which are actively growing such as cancer cells, will take up the sugar and light up on examination. This helps a doctor determine the rate at which the tumor is using the glucose which can help determine the tumor grade. 

A PET scan can be used to detect cancerous tissues and cells in the body that may not always be found through computed tomography (CT) or magnetic resonance imaging (MRI).

 

 

 

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Samadi M.D. by Dr. David Samadi - 4d ago

Get moving to protect prostate health

It’s hard to dispute the tremendous benefits of being physically active.  From helping individuals reach a healthier body weight to reducing the risk of cardiovascular disease, type 2 diabetes and osteoporosis, the list of what physical activity can do for everyone is quite lengthy. 

Something else to add to that list of benefits is exercise’s ability to protect the prostate.  Men who take time to consistently exercise can protect their prostate from various problems they may face as they go through life.  

Why physical activity benefits the prostate gland

A man’s prostate gland lies just below the bladder and has the unique function of producing the fluid which protects and enriches sperm that makes up semen. 

For many years during a man’s life the prostate quietly does its job with few if any problems.   But as a man ages, problems can begin to escalate.  The prostate is prone to painful infections and inflammation (prostatitis), it can grow larger interfering with urination (benign prostatic hyperplasia or BPH), and then there is cancer of the prostate which is the second most common cancer found in American men.

Who would ever guess a gland the size of a chestnut could cause so many issues for men? 

There are many lifestyle habits important for all men to adopt to keep their prostate healthy – eating a healthy diet, maintaining a healthy body weight and not smoking.  Physical activity is another known habit men can take advantage of possibly preventing prostate problems.  Here are reasons why exercise may have a beneficial impact on keeping a man’s prostate in tip top shape that just might give a man an advantage from developing prostatitis, BPH, or prostate cancer:

·      Physical activity and Prostatitis

Prostatitis is inflammation of the prostate gland that is most common in men under the age of 50.  The cause of this condition is usually due to an infection with almost 2 million men who develop it each year.

Prostatitis can either be classified as acute or chronic.  Chronic prostatitis is more prevalent and is characterized by recurrent bacterial infections.  Two different studies have looked at whether exercise could lower a man’s risk of this painful ongoing condition.

The first study looked into the role of physical activity on how it affected chronic prostatitis.  Researchers recruited 231 men with the condition and had not had any luck with conventional treatments.  Participants were randomly assigned to an aerobic exercise group or a placebo/stretching and motion exercise group. 

At the completion of the study, participants assigned to the aerobic exercise group had significantly superior improvements compared to the placebo/stretching and motion exercise group.

A much larger cohort study conducted in 2015 also examined the relation between physical activity and chronic prostatitis of more than 20,000 male health professionals.  Results showed that middle-age and older men with a higher-leisure time physical activity had lower risk of chronic prostatitis compared to men who were not as active. 

·      Physical activity and BPH prevention

BPH is an enlargement of the prostate gland that occurs in men as they age. When the prostate grows larger it can block the flow of urine through the urethra, a tube that carries urine from the bladder out through the penis.  This can lead to urinary difficulties such a frequent urination especially at night.

A study out of South Korea wanted to find out if exercise, as part of a healthy lifestyle, was a protective factor preventing BPH occurrence.  Results showed that reducing sedentary time could have a protective effect on reducing the incidence of BPH. 

Another study of the ongoing Harvard-based Health Professionals Follow-up Study found men who were more physically active were less likely to develop BPH.  They found that even low-to-moderate-intensity physical activity such as walking regularly at a moderate pace provided benefits to the prostate.

·      Physical activity and Prostate cancer

The American Cancer Society states that 1 in 7 men will be diagnosed with prostate cancer during his lifetime.  Most cases occur in older men with the average age being 66 and is rare before age 40.  Next to skin cancer, prostate cancer is the second most common cancer diagnosed in American men.  It would behoove a man to do whatever he could to help prevent it.  Exercise is one way to do this.

A study looking into the evidence of exercise’s benefits on reducing prostate cancer risk found that men who are physically active had lower levels of systemic inflammatory mediators that could decrease development of this disease. 

Another study looked at specific health habits after a prostate cancer diagnosis and the risk of disease recurrence, progression, or death. What was found was that even though diet played a role in prostate cancer progression, it was exercise and smoking cessation that appeared to have a larger impact on reducing the risk of prostate cancer progression and death. 

Making exercise a lifestyle habit

It is no secret exercise must be part of a healthy lifestyle not only for protecting the prostate but in other areas such as cardiovascular health too.  When men adopt a well-rounded, consistent exercise program it can result in benefits to the prostate. 

Men should find an exercise program they enjoy and that their doctor approves of.  Always consult with a doctor before embarking on an exercise routine to make sure it is based on your health and fitness level.

It is best to incorporate an exercise program that includes at least 30 minutes but preferably up to 60 minutes of moderate to vigorous physical activity on all or most days of the week. 

 

 

     

 

     

 

 

 

 

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Samadi M.D. by Dr. David Samadi - 2w ago

What happens during a prostate biopsy

Hearing the words, “You need a prostate biopsy,” can be unsettling and scary.  But it doesn’t need to be. When men understand what a prostate biopsy is, why it’s necessary, and how it is performed, they will gain confidence and self-assurance about the procedure.    

A biopsy is any type of procedure that involves taking a piece of tissue from the body to be examined under a microscope.  A doctor will determine if the tissue contains cancer or abnormal cells.  Depending of the results of the biopsy can help determine the next best step in diagnosis or treatment.  

When it comes to a biopsy of the prostate, your urologist may recommend a biopsy if the result from a prostate specific antigen (PSA) blood test comes back abnormal or has risen to a level that might indicate prostate cancer or a digital rectal exam (DRE) feels suspicious.  Before performing a biopsy, your urologist will take into account your age, general health, family history, ethnic background as well as the results of other testing.  Performing a prostate biopsy will determine whether prostate cancer is present or not, and if so, which treatment option is best and appropriate for the type and stage of cancer diagnosed. 

The basics of a prostate biopsy

What exactly does a prostate biopsy entail?  The procedure itself usually only takes a quick 10 to 15 minutes and is often done in the urologist’s office.  Based upon your risk assessment determined by your urologist, your procedure may vary in the core number of tissue specimens obtained and may include MRI imaging. 

Before the biopsy begins, an antibiotic will be given to reduce the possibility of infection.  During the biopsy, medicine is used to numb the nerves that supply the prostate so you should only feel some pressure but no sharp pain while the procedure is taking place.  This is accomplished by the urologist placing a probe in the rectum and will then numb the area with an injection of a local anesthetic.  Then, the doctor will insert a thin, hollow needle through the wall of your rectum, into the prostate.  When the needle is pulled out, it removes a small amount of prostate tissue.  Multiple tissue samples from different areas of the prostate will be taken.

The samples are sent to a lab where they will be examined under a microscope for abnormal cells with the results coming back in a few days.  If the results are positive for cancer, the biopsy will help your doctor counsel you on your best treatment options.

After the procedure, you will be asked to take it easy for a day or two.  You may feel some tenderness in the area of the biopsy.  There may also be some blood in your urine or you may have some light bleeding from your rectum.  When you ejaculate, you may also notice blood in your semen for up to several weeks.  These symptoms are considered normal after a prostate biopsy, but if they persist or symptoms become worse, contact your urologist as soon as possible. 

Prostate biopsies are considered very safe procedures and are valuable for helping you and your doctor decide on what treatments may need to occur.  Always discuss with your doctor any questions or concerns you may have about your prostate biopsy. 

 

 

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Understanding prostate cancer is your best weapon in fighting it

A diagnosis of prostate cancer is not only upsetting for a man but if his knowledge of prostate cancer is limited, this can possibly set him on the wrong track of knowing how best to fight it.  

Figuring out what needs to be known about prostate cancer can be overwhelming with the decisions, treatment options, and not knowing what the future holds.  To beat back the second leading cause of cancer in American men behind only skin cancer, men need to arm themselves with adequate knowledge of what exactly prostate cancer is. 

The more a man knows and understands what prostate cancer is and knows what he is dealing with, the more he can take charge of his health condition vastly improving his chances of coming okay by defeating it in the end.

Prostate gland and prostate cancer statistics

The prostate is a gland of the male reproductive system which sits below the bladder and in front of the rectum.  Its function is to produce a fluid that contributes to the formation of semen. Normally the size of a walnut in younger men, the prostate can grow much larger as a man ages

Prostate cancer is when cells in the prostate gland grow uncontrollably.  According to the National Cancer Institute (NCI) approximately 14 percent of men will be diagnosed with prostate cancer at some point during their lifetime, based on 2010-2012 data.  This cancer is considered a fairly common one for men with estimates in 2019 of 161,360 new cases will be diagnosed and an estimated 26,730 men will die from the disease.

However, if prostate cancer is discovered in its early stages, it has a 98.9 percent survival rate as reported from the NCI.

Treatment options

Each individual patient’s prostate cancer treatment depends on many factors – the man’s age, overall health, staging of the cancer and its location.   Tailoring a treatment plan best suited for each patient’s unique needs is necessary to have the best outcome.  When the options available are thoroughly explained, a man and his physician will be better prepared to choose the one right for him

The best defense is to have a game plan of good offense when it comes to prostate cancer. 

Men need to have yearly exams to assess what is going on with their prostate.  A simple rectal exam which takes less than a minute and a yearly PSA blood test starting at age 40 are good screening tools urologists use to detect any changes in the prostate gland.  Not getting screened is unwise as a man will be missing his opportunity to catch any changes before it’s too late

Depending on the outcome of the rectal exam and PSA blood test, will determine what the next steps are.  While the PSA test and rectal exam are not perfect, when performed regularly, they still remain the best way to detect prostate cancer.

If abnormalities are found with either the rectal exam or the PSA test, from there the doctor may decide to do a prostate biopsy in which a urologist obtains tissue samples from the prostate gland.  Those samples of tissue are sent to a pathologist to screen the size, shape, and pattern of growth of possible cancer cells and will assign what is called a Gleason score.  The Gleason score is used to describe the aggressiveness of the cancer cells and to predict prognosis and to determine what therapy is best for the patient.

Once the initial diagnostic findings (PSA, Gleason score, rectal exam) are sorted out, from there it will be determined if further imaging tests are required.  The imaging tests could be use of a computed tomography (CT) scan used to determine if cancer has spread outside of the prostate, particularly to the lymph nodes.  Magnetic Resonance Imaging (MRI) is another imaging test using strong magnets to look for cancer that has spread through the edge of the prostate.

After any imaging testing is completed from there treatment options will be decided depending on what stage the cancer is in.  One option a man and his doctor may decide to do is called active surveillance.  This is the decision not to treat prostate cancer at the time of diagnosis based on the man’s age, health condition and the rate of growth of the cancer. 

If the cancer needs to be treated more aggressively, there are several methods of therapy to consider, all depending again on each individual man’s prostate cancer, the expected rate of growth, staging and other factors.  The doctor may decide to choose one type of therapy or a combination to beat back the cancer.  His choices range from the da Vinci prostatectomy, radiation therapy, Cyberknife SBRT procedure, IMRT procedure, seed implant procedure, or hormone therapy

Every man needs to become his own health advocate by becoming familiar with the risk factors and possible signs and symptoms of prostate cancer.  If something doesn’t seem right, men should seek out advice and help from their doctor.  The best way to fight off this potential killer is to get regular checkups, understand the prostate and prostate cancer and to find a urologist who will guide you through the battle every step of the way. 

 

 

 

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Linking the connection between obesity and prostate cancer

Two of the most common medical issues facing men today are obesity and prostate cancer.  When a man is both obese and has prostate cancer, it can be a dangerous combination. This was demonstrated by a 2015 study that showed prostate cancer patients had a greater than twofold association of prostate cancer recurrence when men were obese or had a high body mass index (BMI).  A more recent 2017 study in the International Journal of Cancer, found men diagnosed with localized prostate cancer showed a positive association between long-term weight gain and risk of lethal prostate cancer. This is attributed to metabolic changes associated with weight gain possibly promoting prostate cancer progression.

We know that obesity has many direct consequences on health and is associated with the onset of aggressive cancers, but the mechanisms underlying this phenomenon are not exactly known. With prostate cancer, research has shown there to be a connection between carrying excess weight and developing prostate cancer.

One of the best things a man can do at any age is to reach a healthier body weight. Among lifestyle factors for preventing prostate cancer, obesity is by far the strongest and clearest link to developing an aggressive form of prostate cancer and ultimately a deadly course for this disease.  Another factor having a correlation between obesity and prostate cancer is ethnicity.

The link between obesity and prostate cancer in black men

Black men have the highest rates of prostate cancer cases and the highest rates of prostate cancer deaths in the U.S. Understanding the reasons behind these disparities could influence behaviors that may help lower the risks.

A 2015 study by researchers in Seattle and published online in JAMA Oncology, found that obesity showed a significant increased risk of both low-grade (slow-growing) and high-grade (fast-growing) prostate cancer in black men. More than 3,000 black men and over 22,000 white men were selected to take part in the SELECT trial, a study which began in 2001 to find out whether selenium and vitamin E supplements could help prevent prostate cancer. During the follow-up period of about 5 years, 270 black men and 1,453 white men in the study developed prostate cancer.  Overall, the study found 58% increased risk for prostate cancer among black men when compared to white men. Black men who were obese had an even greater risk. 

Of the obese black men, men who with a BMI of 35 or greater, were more likely to develop prostate cancer, than those with a BMI below 25 (a normal body weight). Obesity among black men was linked to greater risk of both low-grade and high-grade prostate cancer.

The results showing that black men who were obese had a higher risk of prostate cancer, likely stems from social as well as biological factors. Obesity is influenced by a variety of factors, including genetic factors and environmental factors as opposed to a causal relationship between obesity and prostate cancer. 

Prostate cancer risk affected by a man’s height and weight

An interesting study from 2017 found that body size seems to have an impact on a man’s risk of developing prostate cancer. Researchers with the study reviewed data from over 100,000 men and found that for every ten centimeters in height, the risk of developing an aggressive prostate cancer increased by 21 percent. Some of the speculations of possible factors for this finding included that more body mass means more blood, which could dilute the results of a prostate specific antigen (PSA) test possibly leading to a biopsy being performed at a later time, when prostate cancer had had more time to grow. Another theory was men with more fat cells in the body, whether by being obese or tall, could have an impact on how aggressively prostate cancer grows, since fat cells make proteins that can influence cellular growth.

Diet and prostate cancer

While it is not possible to change your ethnicity or height, manipulating weight is another story. Reaching a healthy body weight does takes motivation and self-discipline but it can be done.  Men who develop healthy habits of eating a heart healthy diet will also be doing their prostate health a favor too.

New studies at Cedars-Sinai are being conducted to better understand how losing weight impacts the growth of prostate tumors. In one trial, prostate cancer patients were placed on a diet that was very low in sugar and carbohydrates, resulting in an average loss of 30 pounds in six months.

One of the main focuses of the study is encouraging patients to give up simple sugars found in sweetened beverages, cookies, candy, and other sweets. Sugary foods can lead to an excess of calories along with unhealthy fat leading to high levels of inflammation that is intertwined with obesity and prostate cancer.

Overall, a strong focus for all men should be to consume more heart healthy foods such as omega-3 rich fatty fish (salmon, mackerel, herring, tuna and trout), lean meat, poultry, low-fat dairy, whole grains, fruits and vegetables, and nuts.  Foods men should avoid include chips, pretzels, crackers, processed meats (bacon, sausage, hot dogs, corn dogs, corned beef, bologna, pepperoni, salami, chicken patties, and fish sticks), soda, French fries, burgers, and cheese.

Reaching and maintaining a normal body mass index is achievable by exercising regularly, not over-eating and choosing healthy foods 90% of the time.  Other important lifestyle changes which can impact weight include reducing stress and getting sufficient sleep.  Even if a man who is following this way of living does receive a prostate cancer diagnosis, he will be in a better position of surviving it.

In the meantime, healthy lifestyle changes, talking with their healthcare provider, undergoing regular prostate cancer screening, and knowing risk factors for developing prostate cancer, will be a man’s best bet for beating the odds of a prostate cancer diagnosis.

 

 

 

 

 

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Foods helping and foods harming prostate health

A top health priority for all men should be the health of their prostate.  Prostate cancer is the second leading cause of cancer of American men with one in 6 men who will receive a prostate cancer diagnosis at some point in their lives. 

One way to gain power over reducing prostate cancer risk is through dietary choices.  Granted, there is no absolute guarantee that following a healthy diet will prevent prostate cancer.  But the odds are in a man’s favor if he at the very least, avoids certain foods that have been shown to possibly negatively affecting the health of this gland while including more health-enhancing foods for his prostate.

4 foods hindering prostate health

There are 4 types of foods that have been suggested showing a possible link to overconsumption of them to prostate cancer.   These foods are as follows:

1.  High-fat red meat and processed meat

The World Health Organization has suggested that both red meat and processed meats may be associated with increased risk of developing prostate cancer.  Examples include high fat beef, pork, lunch meat, hot dogs, and sausage.  A diet rich in meat, particularly if it’s cooked well-done, may be associated with an increased risk of developing prostate cancer.  Part of the reason could be due to a substance formed when meat is grilled called heterocyclic amines (HCAs) These are carcinogens found in cooked meat, that have been linked to several cancers

Try instead:

·      Skinless chicken breast

·      Lean red meat

·      Fresh or canned fish such as tuna, salmon, or sardines

·      Beans and legumes such as lentils, split peas, chickpeas, kidney beans, black beans and pinto beans

·      Nut and nut butters

·      Replace the meat in your favorite chili or stew with beans

·      Grill up fish fillets instead of steaks

2.  Alcohol

Over imbibing in alcohol can increase a man’s risk of developing prostate cancer according to reseachers reviewing data of over 10,000 men who participated in the Prostate Cancer Prevention Trial. This study uncovered that heavy alcohol drinkers were twice as likely to be diagnosed with advanced prostate cancer as moderate drinkers.  The definition for heavy drinkers is men who consume more than three drinks a day or more than 20 drinks a week.  Moderate alcohol consumption is defined as no more than two drinks per day.  A drink is defined as a 12 ounce beer, 5 ounces of wine or 1.5 ounces of hard liquor.  

Try instead: 

·      Water or sparkling water mixed with fresh fruit juice

·      Non-alcoholic beers or wine

·      Sparkling juice

·      Tea or coffee

3.  Saturated and Trans fats

Often linked to heart disease, saturated and trans fats also have an association with prostate cancer.  Not all studies have found a link but other studies have shown these unhealthy fats to possibly increase the risk of prostate cancer.  Even if they do not increase the risk, reducing intake of saturated and trans fats may benefit your prostate and overall health.  Avoid foods that include these which are red meat, high-fat dairy products, baked goods, processed foods, butter, bacon, sausage, and heavy cream.

Try instead:

·      Fish with omega-3 fatty acids such as tuna, salmon, mackerel, herring, or trout

·      Avocados

·      Nuts

·      Olive oil

·      Seeds 

4.  Sugary foods and beverages and refined carbohydrates 

Cancer cells can fuel themselves with sugar so it is to a man’s advantage to reduce his intake of foods containing too much of the sweet stuff.  This would include all sugary beverages such as soda or sweetened tea, along with cookies, pie, cake and other sugary concoctions.  Refined carbohydrates would be white rice or items made with white flour.  These type of foods are devoid of fiber and important vitamins and minerals than could be helpful reducing prostate cancer risk. If a man’s diet lacks color because of too many sugary/refined foods, his prostate health could suffer. 

Try instead: 

·      Fresh or frozen fruits and vegetables

·      Make half your plate filled with fruits/veggies

·      Use whole grains such as 100% whole wheat bread or brown rice

4 foods enhancing prostate health

Even though there is no definitive evidence good nutrition can prevent prostate problems, eating a healthy balanced diet may reduce a man’s risk.  The best bet is to build meals and snacks around vegetables and fruits as a start which always enhances health in general and especially a healthy prostate. 

Here are 4 foods that can do just that:

1.  Berries

All berries (blueberries, blackberries, raspberries, strawberries), are high in vitamin C and antioxidants which play an important role in the body.   Include some type of berry every day to help prevent damage from free radicals, molecules that attack healthy cells which can contribute to cancer. 

2.  Fatty fish

Fatty fish such as salmon, trout, tuna, herring, mackerel, and sardines, are excellent sources of omega-3 fatty acids. A review paper found that omega-3 fats modulate prostate cancer development, likely because of their anti-inflammatory effects, and ultimately may inhibit tumor growth.  Aim for two servings (one serving is 3.5 ounces) of omega-3 rich fish a week.

3.  Nuts

Nuts are one of the best go-to snacks around.  They contain healthy fats to help lower cholesterol and promote brain health.  Brazil nuts in particular, are rich in the mineral selenium.  A 2010 study suggests that selenium along with soy may help fight prostate cancer.  One Brazil nut contains 100 percent of the daily value of selenium – be careful on the portion size as too much selenium can be harmful.  Other nuts to consider include pecans, almonds, and walnuts. 

4.  Beans

Here’s a good nutritional swap boosting prostate health – replace red or processed meats with plant protein.  Beans are chock-full of protein and other vital nutrients benefitting prostate health.  One cup of beans has about 15 grams of protein and 15 grams of fiber – men consuming more fiber may benefit from a carbohydrate found in high-fiber diets called IP6 which might control the progression of prostate cancer.  Ideally men should aim for about 38 grams of fiber a day. 

 

 

 

 

 

 

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Questions men should ask about prostate cancer screening

Just like women are highly encouraged to have a yearly mammogram in order to detect breast cancer, men past the age of 40, are encouraged to have regular prostate cancer screenings. Other than skin cancer, Prostate cancer is the most common type of cancer found in men and is the second leading cause of cancer death in American men, behind lung cancer. 

For the year 2019, the American Cancer Society estimates that in the U.S., around 174,650 new cases of prostate cancer will be diagnosed and about 31,620 men will die from the disease. Throughout the course of a man’s life, about 1 man in 9 will be given a diagnosis of prostate cancer (African American men face a 1 in 3 chance) and about 1 man in 41 will die from this cancer.

While prostate cancer is a serious disease, most men given a diagnosis of it, will not die from it. Over 2.9 million men in the U.S., who have been given a diagnosis of prostate cancer, are alive today, thanks in part, to prostate cancer screenings. Without these important screening tests, many more men may not have been discovered until the disease had metastasized or spread, making it more difficult to treat and increasing the risk of death.

Questions men should ask their doctor about prostate cancer screening

Prostate cancer screening has been debated many times over the years.  There are varying differences of opinion as to when to begin screening for the disease and concerns on over-treating nonaggressive or slow-growing forms of prostate cancer.  To get a clearer picture of what to do, men should ask the following questions of their primary care physician or their urologist:

·      What is prostate cancer?

Prostate cancer is cancer occuring in a man’s prostate – the walnut-sized gland in the male reproductive system. It is located below the bladder in front of the rectum and surrounds the upper part of the urethra, the tube that empties urine from the bladder. The prostate helps regulate bladder control and produces the seminal fluid that nourishes and transports semen.

·      What causes prostate cancer?

It is not known what specifically causes prostate cancer, but there are several risk factors for the disease:

·      Advanced age

·      Being African American

·      Having a father, brother, or son who had  prostate cancer

·      When should I start testing for prostate cancer?

The best place to start when wanting to learn more information about PSA testing is to discuss the matter with your doctor. There is much debate as to what age to start PSA screenings. It is strongly advisable to begin with a baseline PSA screening around age 40.  Men can and do develop prostate cancer younger than the age of 50 and when they do, it can be more aggressive and difficult to treat.  Ask your healthcare provider about the benefits and risks of PSA screening and also be aware of risk factors that can increase your risk for developing prostate cancer, including:

Currently, the U.S. Preventive Services Task Force recommendation on screening for prostate cancer is as follows: Based on a review of the evidence, the Task Force recommends that men aged 55 to 69 years make an individual decision about whether to be screened after a conversation with their clinician about the potential benefits and harms. For men 70 years and older, the potential benefits do not outweigh the expected harms, and these men should not be routinely screened for prostate cancer.

·      What is the test used to screen for prostate cancer?

Prostate specific antigen is a protein produced by normal as well as malignant cells of the prostate gland and is found in the blood.  The PSA test measures the level of PSA in a man’s blood.  For this test, a blood sample is sent to a laboratory for analysis.  The results are usually reported as nanograms of PSA per milliliter (ng/ml) of blood.  The blood sample taken is used to monitor the level of PSA being produced by the prostate. 

The PSA test became available in the early 1990s and is a simple test used to monitor the PSA levels over a period of years.  When this is done regularly, urologists are much better able to detect spikes or elevations in a man’s PSA level.  One aspect looked at is PSA velocity.  PSA velocity is the rate at which a man’s PSA levels change over a period of time.  PSA mapping is the best way to determine if elevations are a cause for concern such as prostate cancer. 

·      Are there factors besides cancer that can influence the outcome of a PSA test?

If a man’s PSA test comes back higher than normal, it does not automatically mean prostate cancer. There can be many other reasons besides prostate cancer affecting a PSA reading including the following:

·      Prostatitis or inflammation of the prostate

·      Urinary tract infection

·      Benign prostatic hyperplasia (BPH) which is an enlargement of the prostate

·      Injury to the prostate

·      Treatments such as prostate biopsies (tissue samples) or cystoscopy which is a test to look inside the urethra and bladder

Results of a PSA test can also be influenced by other factors such as:

·      A man’s age - blood PSA levels tend to rise with age

·      Men with larger prostates make more PSA

·      Change in PSA levels over time (known as PSA velocity) can be markers of both cancer risk and how quickly a cancer may be growing

·      What is a normal PSA level?

There is no specific normal or abnormal level of PSA in the blood, and levels may vary over time in the same man. Most doctors consider anything over 4.0 ng/ml or 4 nanograms per milliliter of blood, as above the typical range.

However, more recent studies have shown that some men with PSA levels below 4.0 ng/ml have prostate cancer while some men with higher levels do not have prostate cancer. In general, the higher a man’s PSA level, the more likely it is a greater likelihood he has prostate cancer and rising levels over time are also a warning sign.

·      How will I know if I need a biopsy?

Based on findings from a PSA test, the decision to have a prostate biopsy should be determined together with your healthcare provider. Other factors to take into consideration include your family history of prostate cancer, your race, results of any prior biopsies, and other major health your issues you may have.

·      If I have prostate cancer, should I see a urologist or oncologist for treatment?

There are several types of doctors who treat prostate cancer which include:

·      Urologists: surgeons who treat diseases of the urinary system and make reproductive system including the prostate

·      Radiation oncologists: doctors who treat cancer with radiation therapy

·      Medical oncologists: doctors who treat cancer with medicines such as chemotherapy or hormone therapy

·      Surgical oncologists: doctors who treat cancer by removing tumors and surrounding tissue during an operation. Surgical oncologists also perform certain types of biopsies.

·      What is my chance of surviving prostate cancer?

While being screened for prostate cancer may sound scary, for the vast majority of men who contract the disease, the majority will survive it.  In fact, the 5-year survival rate for most men with local or regional prostate cancer is nearly 100%.  Ninety-eight percent are alive after 10 years. For men diagnosed with prostate cancer that has spread to other parts of the body, the 5-year survival rate is 30%.

Get screened – not only can it save your life but give you peace of mind in leading a healthy, quality life.

 

 

 

 

 

 

 

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A day in the life of your prostate gland

It is commonly known what our heart or our eyes do all day long.  But, what does the prostate gland do each day?   What kind of duties does it have and how important are they? Men are aware that their prostate gland performs certain functions but when asked what it does, few realize the various jobs this busy organ has.  For a small gland the size of a walnut, the prostate is responsible for keeping the male reproductive system on task. Located in front of the rectum and just below the bladder surrounding the urethra, over the course of a day, it has plenty of things to do keeping it busy.

Let’s take a look at the many functions the prostate gland performs helping keep the male reproductive system up and running:

·      Produces prostatic fluid

The most important function of the prostate is for the production of a fluid that, together with sperm cells from the testicles and fluids from other glands, makes up semen.  Seminal fluid is designed to carry and nourish sperm.  The prostate gland’s contribution to this mixture is to provide an alkaline mixture of calcium, enzymes, and other components that make up about 30% of the seminal fluid.  The alkaline fluid helps to neutralize the acidic vaginal environment which would otherwise kill sperm.

·      Expels semen out of the body

Besides producing part of the seminal fluid for sperm to survive in, the muscles of the prostate are responsible for forcefully discharging sperm into the urethra helping to expel sperm outwards during ejaculation.  The vigorous expulsion during ejaculation ensures that the sperm can travel far enough into a woman’s vagina to reach the fallopian tubes for fertilization of an egg.

·      Produces prostate specific antigen (PSA) which helps with fertility

Prostate specific antigen (PSA) is a protein produced by epithelial cells of the prostate gland. PSA helps semen to become fluid carrying the sperm on out of the body. Because of PSA, this enables sperm to swim into the fallopian tubes where fertilization takes place, keeping the semen in liquid form. This increases the likelihood of sperm successfully fertilizing the ovum or egg from a woman.

·      Creates and maintains erections 

The nerves within the prostate have a part in creating and maintaining erections during sex.  These nerves are responsible for eliciting extra blood to flow into the penis helping it to swell and become firm.

·      Filters sperm

To remove any toxins that could prevent sperm from doing its job, the prostate acts as a filter removing any potential toxic substances. 

·      Controls urine flow

The prostate is in charge of controlling urine flow down the urethra in addition to stopping urine from leaving the bladder until it a man urinates.  The prostate also prevents urine from mixing with sperm when a man ejaculates.  If the prostate becomes enlarged, this will put pressure on the urethra which can result in issues with urination for a man.

·      Protects against urinary tract infections

Prostate secretions can help protect the urethra from urinary tract infections.

·      It is considered the “G-spot” of a man

The prostate gland has been referred to as a man’s “G-spot” and if stimulated during sex can possibly lead to an intense orgasm for men.  This may not be an area of adventure some men want to try out but for the more intrepid souls, it could prove to be well worth the effort.

     

 

 

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Large long-term study shows prostate cancer death reduced by PSA screenings

A Swedish study which followed 20,000 men for more than two decades found that men who had a prostate specific antigen (PSA) blood test, used to test markers of prostate cancer, slashes deaths from this disease by almost 30%.  This research is the longest screening study on prostate cancer to date.

PSA controversy

It has been questioned by prostate cancer authorities and still remans one of the most controversial topics among urologists of whether a PSA test should be conducted routinely.  What is known and is agreed on is that PSA testing does save lives.  The controversy involves whether it’s worth the risk to do routine screening which some urologists believe can lead to overdiagnosis and thus overtreatment of otherwise harmless cancers. 

Worldwide, most countries current guidelines suggest that PSA testing should not be offered by itself for diagnosing prostate cancer. This new study, however, shows the value of the long-term effects of an organized screening program in Sweden which challenge the current recommendation.

Findings from Swedish study

Based on data from the Randomized Population-Based Prostate Cancer Screening Trial, that included 20,000 men living in the city of Goteborg in 1994. The men in the study ranged in age from 50-64 years old and were randomly assigned to receive a PSA test every two years – along with a biopsy if PSA levels were elevated – or to a control group not offered PSA screening.

The findings from this study showed that after 22 years of follow-up, approximately 1,528 prostate cancers had been detected in screened participants, compared to 1,124 in the control group. Interestingly, the cancers in the screening group were found at an earlier stage, which led to a 29% reduction in prostate cancer deaths. In total, 112 screened men died from the disease, compared to 158 deaths in the control group.

Another finding was that three groups of men had a higher risk of death because of prostate cancer.  These men included those whose disease were detected during the first screening (all were over the age of 60); men diagnosed after leaving the study; and men who were invited to the screening group, but did not participate.

The men in the last group that did not participate (referred to as non-attenders), had a lower incidence of prostate cancer than attenders.  This was believed to be due to the fact most had asymptomatic, low-grade prostate cancer that were not detected, but were three times more likely to die of the condition.

Of the men who were diagnosed with prostate cancer after the study was done, were less likely to receive curative treatments.  The reasoning for this is likely because they were older and less likely to endure aggressive treatments. This points to the fact that PSA screenings should begin earlier in a man’s life.

PSA screening does save men’s lives when done routinely and when they begin at around age 40.  All men should discuss with their doctor of when to begin PSA testing and know of the signs and symptoms of prostate cancer.  When men become actively involved in the health of their prostate, the more men who can be saved from dying of prostate cancer.

 

 

 

 

 

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Famous men who’ve faced prostate cancer

Like all cancers, prostate cancer doesn’t discriminate.  It can and does affect men of all backgrounds from rich to poor, from black to white, to the average Joe to men of celebrity status.  Prostate cancer affects about one in seven men who will be diagnosed with this disease in their lifetime.  According to the Centers for Disease Control and Prevention (CDC), prostate cancer is the second leading cause of cancer death in American men, behind lung and bronchus cancer and about 1 man in 39 will die because of it.

Even men in the public eye cannot evade prostate cancer’s presence.  Despite their fame, these men with household names each shared a common trait – prostate cancer.  Their struggles with the disease are as unique as their wide range of talents. 

Here is a look at famous men who were given a diagnosis of prostate cancer.  Each man has his own distinctive story to tell in how their prostate cancer was ultimately found, treated, and for the vast majority, conquered:

·      Roger Moore

Probably best known for his role as “James Bond,” Moore was diagnosed with prostate cancer in 1993. A self-proclaimed hypochondriac, Moore faced his worst fear of undergoing a radical prostatectomy (removal of the prostate gland) making a full recovery. 

·      Sir Ian McKellen

This actor had an illustrious career spanning almost 55 years that ranged from the stage to the silver screen.  Best known for his roles in X-Men and The Lord of the Rings trilogy, McKellan was diagnosed in 2006 with prostate cancer.  It wasn’t until six years later in 2012, when McKellan finally revealed his disease to the public, stating he had been monitoring the disease through active surveillance.

·      James Brown

It was in 2004 when “The Godfather of Soul” was diagnosed with prostate cancer and was able to successfully treat it the same year after undergoing surgery for it. He passed away two years later at the age of 73 from a weeklong battle with pneumonia.

·      Frank Zappa

This well-known musician, composer, recording engineer, songwriter, record producer, and film director, Zappa was given the news he had prostate cancer in 1990.  Unfortunately, the cancer was detected too late to be considered operable.  He passed away in 1993.

·      Ben Stiller

Stiller took the route of publically revealing in 2016 on The Howard Stern Show his diagnosis at the age of 48.  With no symptoms or family history of prostate cancer, Stiller found out he had the disease when he had a prostate-specific antigen (PSA) test at a yearly physical.  He underwent surgery to remove his prostate gland and continues to have PSA tests every six months screening for any recurrence of the cancer.

·      Jerry Brown

At the age of 73, California governor Jerry Brown announced he was being treated for early-stage prostate cancer.  As he underwent radiation therapy, Brown continued to work and in early 2013, he reported his treatment was done and he was doing well.

·      Robert De Niro

Academy Award winner Robert De Niro, known for playing “tough guy” roles, was diagnosed with prostate cancer in 2003 at the age of 60.  Because of regular checkups, De Niro’s cancer was caught at an early stage and has since gone on to make a full recovery.

·      Colin Powell

Powell has been a vocal supporter of prostate cancer awareness devoting his time to the Prostate Conditions Education Council since his cancer was found in 2003.  This former Secretary of State and retired four-star general in the U.S. Army underwent surgery to remove his prostate gland at Walter Reed Army Medical Center

·      John Kerry

While running for President of the United States in 2002, Kerry received some news he wasn’t expecting – prostate cancer.  His father had died from this same cancer at the age of 85.   He had his cancer treated with surgery with no recurrence and now leads a post-cancer lifestyle of regular exercise and eating a healthy, well-balanced diet. 

·      Ryan O’Neal

At the time of Ryan O’Neal’s diagnosis of prostate cancer, it was not his first bout with cancer.  In 2001, he was diagnosed with chronic myelogenous leukemia which is now in remission.  Initially when he was told of his prostate cancer in 2012, it was placed at a stage 4 but later was downgraded to stage T2b meaning it was confined to the prostate and had not spread.  He was treated with targeted cryotherapy as he wanted as few of side effects as possible.

·      Arnold Palmer

Palmer is a golf legend winning 62 PGA Tours earning him a spot in the World Golf Hall of Fame.  But his proudest accomplishment was beating back prostate cancer.  It was in 1997 when Palmer was diagnosed and treated with a radical prostatectomy and radiation.  He utilized his fame and fortune to raise awareness of the disease by establishing the Arnold Palmer Prostate Center in Rancho Mirage, California. 

·      Rudy Giuliani

Former New York City Mayor Rudy Giuliani was given the same diagnosis in 2000 as his father was given 19 years earlier.  To beat back his cancer, Giuliani chose an aggressive multiphase treatment plan that consisted of four months of hormone therapy, implantation of radioactive pellets in his prostate and five weeks of almost-daily external-beam radiation with continuing hormone therapy.  This grueling routine worked and he is doing well.

·      Harry Belafonte

Famous for his singing of “The Banana Boat Song,” this actor, activist, and singer/songwriter had to play the role of cancer survivor when he was told he had prostate cancer in 1996.  He underwent surgery and has even been candid enough to talk about his post-surgery struggles with incontinence, a common side effect.  He stated he was able to overcome it by faithfully doing Kegels for a solid year.

 

·      Warren Buffett

One of the most successful investors of the 20th century, Warren Buffett announced in 2012 he had stage 1 prostate cancer to his shareholders of Bershire Hathaway after he had been told his PSA blood test came back high.  He made the decision to undergo 44 days of radiation therapy even though he was criticized by some cancer specialists that his cancer was not life-threatening or even debilitating as to be concerned about.  He is doing fine today with no harm done. 

 

  

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