Prostate Cancer Screening Still a Life-Saver
By Craig Rinder, MD
One of my most important jobs as a urologist is to keep men out of my office. This is not because I do not care about my patients, but rather because I know that one of the most important ways to safeguard the health of the men in our community is to educate them about available 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 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.
The prostate is a simple gland responsible for a large part of men’s reproductive health throughout their lives. Prostate-specific antigen, or PSA, is the most significant enzyme secreted by the prostate, and can easily be assessed using a simple blood test. Elevated PSA levels are an indication of risk, but do not necessarily mean a man has prostate cancer. PSA testing, in conjunction with a rectal exam, helps assess a patient’s overall profile for prostate cancer.
There is a common misconception 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 approximately double if we were not doing the amount of prostate cancer screening that we are doing now. Early detection allows us to treat the cancer before it has the chance to spread to adjacent organs, or even further into the lymph nodes or bones.
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.
Prostate cancer screenings can and should be offered by a man’s primary medical provider beginning at age 45, according to the American Urological Association. Family physicians, nurse practitioners, and physician assistants are all qualified to do the screening. If a high PSA level is detected, there may not be a need to take any immediate action 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 who may recommend an ultrasound and a biopsy, following which you would discuss the best options for any necessary treatments.
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. Surgery on younger and healthier men is usually the better choice because the long-term control of the cancer is better. Surgery has slightly better outcomes, statistically speaking, 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 probably will not have one at all. This can mean a long, cancer-free life for those patients who are diagnosed and treated in their forties and fifties.
Talk to your provider about prostate screening during your next routine physical. The sooner you take charge of this simple healthcare decision, the more likely you will be to minimize the amount of time spent in doctors’ offices over the coming years.
Craig Rinder, MD, is a board-certified urologist for BMH Urology, a department of Brattleboro Memorial Hospital. Learn more, visit bmhvt.org/bmh-urology.