One of my most important jobs as a urologist is to keep men out of my office. Not because I don’t care about them, but because I know that one of the most important ways to safeguard men’s health is to educate patients about options that will minimize the need for serious medical interventions throughout their lives. The simplest and most crucial of these health options is regular prostate cancer screening.
Prostate cancer screenings are vital to men’s health. That’s because early detection and treatment of prostate cancer is the single most important factor in patient outcomes. Men who are tested early and regularly have the best chances of living long and cancer-free lives.
What is the prostate?
The prostate is a simple gland that supplies part of the fluid that makes up semen. It’s responsible for a large part of men’s reproductive health throughout their lives. Prostate-specific antigen (PSA) is the most significant enzyme secreted by the prostate, and can easily be assessed using a simple blood test. Elevated PSA levels may indicate risk, but do not necessarily mean a man has prostate cancer. PSA testing, along with a rectal exam, helps assess a patient’s overall profile for prostate cancer.
A common misconception is that prostate cancer is harmless and does not require treatment. The fact is that in a given year, 28,000 men will die of prostate cancer. That number would be roughly double if we were not doing the amount of prostate cancer screening we are doing now. Early detection allows us to treat the cancer before it spreads to nearby organs, or even further into the lymph nodes or bones.
The risk of prostate cancer should be taken seriously
People think prostate cancer is not a problem because it does not present with any outward symptoms and because it grows more slowly than other cancers. In 10 years, most men diagnosed with prostate cancer will not have died from it. However, most men with untreated prostate cancer will die within 15 to 20 years, either from the cancer or from a related complication. Luckily, we are able to detect and treat most cases of prostate cancer.
The American Urological Association recommends prostate cancer screenings begin at age 45. Family physicians, nurse practitioners, and physician assistants are all qualified to do the screening. If a high PSA level is found, immediate action may not be required other than waiting for a period of time and doing another PSA test. If a lump is felt or there is concern about PSA levels, the provider will make a referral to a specialist. He or she may recommend an ultrasound and a biopsy, following which you would discuss the best options for any necessary treatments.
Prostate cancer treatments are highly effective
Radiation and surgery are the two most commonly used treatments for a localized prostate cancer. Radiation is safer for people who have other health problems, such as heart disease, that may be complicated by surgery. For younger, healthier men surgery is usually the better choice. That’s because the long-term control of the cancer is better. Statistically, surgery has slightly better outcomes. But the success rate for each treatment can be expected to be between 80 and 90 percent.
We conduct follow-up visits with patients for the rest of their lives. Research tells us that if a patient does not experience a recurrence of his cancer in 10 years, he’s not likely to have one at all. This can mean a long, cancer-free life for men who are diagnosed and treated in their forties and fifties.
Talk to your provider about prostate screening during your next physical. Take charge of this simple healthcare decision today. It will help minimize the amount of time you spend in doctors’ offices over the coming years.
Craig Rinder, MD, is a board-certified urologist for BMH Urology, a department of Brattleboro Memorial Hospital.