September is Prostate Cancer Awareness Month. Prostate cancer is common and grows slowly. At onset, symptoms may be absent, but as it progresses, early warning signs include an increased urgency to urinate, frequency, and leaking. In more advanced stages, the cancer can metastasize to other organs such as the lungs, liver, and brain. In a majority of cases, bone pain will occur.
According to the American Cancer Society, cancer of the prostate is the second most common cancer, and men are 44 percent more likely to develop it than women.
Mehmet F. Hepgur, M.D., an oncologist/radiologist at Broward Health in Fort Lauderdale, says that depending on the size of the tumor, a person may feel pain in the prostate and see blood while urinating. “The only way to detect the specific stage is through an examination and taking a test to determine a person’s PSA (prostate-specific antigen) level,” said Dr. Hepgur. “The best chance for a successful treatment is through early detection when the tumor is still confined within the prostate gland.”
The PSA test is not for cancer detection but a means of measuring the levels of a specific antigen in the prostate gland. The PSA numbers can indicate other issues ranging from inflammation and infection to gland enlargement and subsequent cancer. According to the Prostate Cancer Foundation, a high PSA level does not always indicate prostate cancer. There are numerous types of prostate cancer, and there’s a treatment for each type. In summary, one approach doesn’t fit everyone, and treatment is on a case-by-case basis.
“A person in their 40s or 50s with a PSA greater than 3 milligrams per milliliter is abnormal and may need a further workup,” said Dr. Hepgur. “The PSA range is usually less than 1. For a person in their 70s, a PSA above 4 is abnormal, and if it rises above 0.3 milligrams per milliliter a year, additional testing is required.”
It’s important to identify prostate cancer in its early stage and to be aware of any history of cancer in the family, genetics, or abnormal lifestyle habits. “Reports show that African-American men have a higher incidence rate and may have to be screened at a younger age,” said Dr. Hepgur. “There’s no hard data to show why certain ethnicities have higher rates of incidence, but we encourage earlier screenings as the best method of prevention.”
There is debate in some circles about the age at which screenings should begin. The primary recommendation is between 55 and 69 years of age. “Exercise is important, as is cutting down alcohol consumption,” said Dr. Hepgur. “It’s critical to be screened at the proper time and talk to your doctor about treatment options.”
Older men and women with prostate cancer are under “active surveillance.” Specialists find that surgical versus radiation outcomes are very similar. In advanced stages, however, it’s recommended to see an oncologist for treatment protocols.
Dr. Hepgur’s advice is to be aware of any history of cancer in the family and of any genetic predisposition, and to live a healthy lifestyle through exercise and nutrition.