Living Well: Know Your Risks For Prostate Cancer
To screen, or not to screen?
Our knowledge of the human body is changing constantly, and that means the expert recommendations for how to live a healthy life change, too. Understanding those changes can be difficult, and that’s where talking to a healthcare professional can do you a world of good.
September is National Prostate Cancer Awareness Month, which means it’s a great time for men to increase their awareness about risks for this type of cancer.
The State Of Your Prostate
What exactly is the prostate?
This gland, which is about the size of a walnut and is only found in men, plays a role in processing testosterone and is a key part of the male reproductive system. It also affects your urinary health because the urethra, which carries urine on its way out of the body, runs through it.
As men age, the prostate can undergo changes. Some of these are benign, or harmless, though they can cause problems with urination. Others can lead to prostate cancer, which 1 in 7 men will be diagnosed with in their lifetime. In 2016, the American Cancer Society estimates that 180,890 men will be diagnosed with prostate cancer and another 26,120 will die from it.
Prostate cancer screening involves two parts: A blood test for prostate-specific antigen and a digital (finger) examination of the prostate. These two parts of the screening are far more effective when done together, so it’s essential to do both. When done at the right times, these can help decide if a tissue biopsy, where cells are removed and analyzed for signs of cancer, is needed.
Who Is At Risk?
The greatest factor that increases the risk of prostate cancer is age. It’s rare before the age of 40, and the majority of cases are diagnosed after age 60. The average age of diagnosis is 66.
Genetics are also a factor. African-American men show higher rates of prostate cancer, though we’re not sure why that is. Family history is also an important indicator. The risk of prostate cancer doubles for men who have a father or brother with the disease. Family history isn’t required to develop it though, so screening is important for all men as they age.
There’s also evidence to suggest that other factors play a role. Smoking, unhealthy diet and lack of physical activity may also play a role, so more research is needed before we can say these are definitely connected. Still, living a healthy lifestyle is proven to be good for you, so you should stay smoke free, eat right and exercise whether or not these reduce your risk of prostate cancer.
Who Should Be Screened?
The American Urological Association is our go-to source for guidance on these topics, and we follow their advice pretty closely. The most important factor is a discussion between provider and patient to determine whether screening should be done. The most-recent screening guidelines, release in 2013, are as follows:
- Ages 40 and under: Routine screening is not recommended for men in this category. Because of their age, they are at very low risk for developing prostate cancer.
- Ages 40-54: Routine screening is not recommended for men with low to average risk. For men at high risk, those with a family history or African-American men, screening should be considered. Men are encouraged to talk to their doctor to get the information they need to make a decision.
- Ages 55-69: Screening is encouraged for men in this category.
- Age 70+: Screening is not recommended for men in this category. Those who have a life expectancy of greater than 10 to 15 years may consider being screened, but are encouraged to discuss this with their doctor before deciding.
- Frequency: The AUA has recently begun recommending that men who are screened have it done every two years.
Why all the exceptions? Since the early effects of prostate cancer resemble processes men often normally experience as they age, the only way to be sure is to do a biopsy. Though uncommon, prostate biopsies can have side effects, including infection.
Prostate cancer is also slow-growing and it is not always aggressive enough to be fatal, so it may be better to not screen those with a shorter life expectancy. This avoids the risk of side effects from a biopsy. It also keeps these men from unnecessarily going through cancer treatments that might not benefit them by extending their life or improving its quality.
The most important thing is for men to have a conversation with their healthcare provider. Our goal is to give you the longest, best-quality life possible. We’ll do everything we can to help you make that happen.
Dr. Robert Lewe is a board-certified urologist with Owensboro Health Medical Group. Request an appointment with Dr. Lewe.
This article was originally published in the Owensboro Messenger-Inquirer.