Prostate Cancer: Advances in Screening and Treatment

Daily Herald (Arlington Heights, IL), September 4, 2017 | Go to article overview

Prostate Cancer: Advances in Screening and Treatment


Byline: Melissa Hollander mhollander@dailyherald.com

Prostate cancer: Advances in screening and treatment

September is National Prostate Cancer Awareness Month.

Prostate cancer is the most common nonskin type of cancer. Approximately one in seven men in the United States will be diagnosed with prostate cancer at some point in their lives.

Dr. Brian Helfand, a board-certified urologist and director of the Prostate Cancer Program at the John and Carol Walter Center for Urological Health at NorthShore University HealthSystem, answered questions about prostate cancer and the future of treatment for it.

Q. What is the prostate?

A. The prostate is a walnut-sized organ that is located just underneath the bladder. The urethra (or tube where a man urinates) runs through the center of the prostate.

The prostate's normal function is to secrete fluid that nourishes and protects sperm. During sexual intercourse, the prostate squeezes this fluid into the urethra and it is expelled as ejaculate fluid. Because of this function, I always tell patients that the prostate is necessary for normal sexual reproduction.

However, after reproductive years, the prostate can cause problems: 1) It can exhibit noncancerous growth called benign prostatic hyperplasia or 2) Develop cancer.

Q. What are symptoms and risk factors for prostate cancer?

A. Many men with prostate cancer have increased urinary symptoms such as a weakened or slow stream. In addition, men with metastatic prostate cancer often present with new bone or back pain and sometimes even with unexplained weight loss.

However, since the introduction of the serum blood test called prostate specific antigen (PSA), men are typically diagnosed when the cancer is still confined to the prostate. At this stage, the vast majority of men are without symptoms. This is the ideal time to diagnose and treat men.

African American men are considered to be at higher risk of prostate cancer and are recommended to have earlier prostate cancer screening.A family history of prostate cancer also increases the risk of being diagnosed. The American Urologic Association recommends earlier screening among men with a family history of the disease.

However, it is important to recognize that the vast majority of men do not report a family history of prostate cancer. As such, I believe that every healthy individual should have a discussion with his primary care physician or urologist about the risks and benefits of undergoing PSA testing.

The most common test that is used for prostate cancer screening is the PSA test. This is usually paired with a digital rectal examination.

Q. Besides the PSA testing, what other screenings are available?

A. Within the past several years there are newer blood tests that can estimate the risk of prostate cancer. One such test that will be available commercially is called the Genetic Risk Score. This blood test measures a number of different variations in a man's DNA that are associated with prostate cancer risk.

A man is born with a fixed number of these variations called single nucleotide polymorphisms and they do not change over a lifetime. The number of SNPS that an individual carries is associated with increased or decreased risk. Knowing this type of genetic information will help to stratify disease risk and also help guide the frequency and intensity of PSA testing.

Q. What are the guidelines for prostate cancer testing?

A. Unfortunately, different authoritative groups differ on guideline recommendations for prostate cancer screening. Some recommend a baseline PSA at age 45 and other groups recommend waiting until age 55.

However, I believe that a discussion about the risks of prostate cancer should be undertaken with every man at an early age. This informed discussion will act as a platform that can guide the timing and initiation of prostate cancer testing. …

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