Prostate Cancer – A Challenging Diagnosis

By Virginia Carnahan, APR, CPRC
Director of Development

With the hustle-bustle of the holidays behind us, perhaps it is time to refocus our attention on health and happiness for this New Year.  This message is meant for men, but the information it contains is also good for women to know.

First, men need to recognize that regardless of how healthy they think they are, there are some health challenges that they face simply because they are men.  The biggest of these is prostate cancer, or prostate issues such as BPH (an enlarged prostate gland) and prostatitis (infection of the prostate).

Statistics tell us that one in six men will develop prostate cancer in his lifetime.  This is an even larger threat than breast cancer is to women!  Some men are at greater risk than others.  These include any man who has a family history of prostate cancer (a father, uncle or brother who has been diagnosed with prostate cancer); any man who has been exposed to Agent Orange (Vietnam era veterans); and African Americans (six times greater incidence).  There are also hundreds of thousands of men who don’t fall into these categories who develop prostate cancer each year.

Why does a man develop this cancer?  The answer is the same for why women develop breast cancer, or uterine cancer or ovarian cancer.  The simple explanation is that there is something in the human DNA that causes cells to spontaneously mutate with age into rogue (cancer) cells.  This is particularly evident in organs that are hormone dependent.  Much effort and many research dollars have been invested in trying to learn how this happens, in hopes of being able to stop or slow this mutation.  Until the key is found to turning off this mutation, our best hope lies in finding these diseases when they are early in the development and at a treatable stage.

If there is a “good thing” to prostate cancer, it is that the disease produces an antigen that can be detected in the blood and considered a “red flag” that something abnormal is going on in the gland.  This is the “PSA” (prostatic specific antigen) level that should be part of every man’s annual health exam starting at about age 50.  However, if there is a family history of the disease we recommend annual screening at age 40.

There is a “normal” PSA level that when surpassed serves to alert physicians of a potential problem.  The PSA (like blood pressure and cholesterol levels) should be tracked overtime to accurately understand the relative health of the prostate gland.

Prostate cancer, however, is a very tricky diagnosis.  While PSA (and a digital rectal exam) can tell the physician a great deal about the prostate gland, it takes an invasive procedure to actually diagnose the disease.  A biopsy is required to diagnose prostate cancer (as well as any other type of cancer).   There are several methods available to perform the biopsy.  The objective is the same – to extract tiny cores of prostate tissue that can be examined under a microscope by a pathologist in order to identify cancerous cells.

Unfortunately the biopsy is not an exact science.  When random samples are extracted there is a high likelihood that none of the 6 or 8 or 12 cores actually penetrate an area where cancer is growing.  In this case, the man may be told his biopsy was negative, when in fact there are cancer cells growing in the gland.  This man has gotten a “false negative.”  Next year when he gets his annual checkup his PSA may be even higher and he will undergo another biopsy.  Sometimes it takes 5 or 6 biopsies before the random sample happens to find where the cancer has been growing.

Once a diagnosis has been made, the man begins a journey he wishes he didn’t have to take.  He, along with his doctor, will need to decide if the cancer should be treated now or ever, depending on the stage of the cancer, the man’s age, his other health issues and other factors.  If he elects to be treated, another challenge is at hand – which treatment should he choose?

Currently there are about a dozen different types of treatment for prostate cancer that are found in the mainstream of modern medicine.  There are also dozens of unproven “internet” suggestions that can be a total waste of money, and worse can mask the PSA so that the man thinks he is defeating the cancer while it is still growing.

To learn more about prostate cancer and the recommended treatment options, we offer a booklet entitled “The Dattoli Challenge: Evaluating Your Prostate Cancer Treatment Options.”  If you are interested in receiving a complimentary copy, please give us a call.  We can also send you a helpful chart describing all the current types of treatment available for prostate cancer.

DATTOLI CANCER CENTER
1-877-DATTOLI | www.dattoli.com