Prostate Cancer Awareness Urged

Prostate cancer is the most common nonskin cancer in men and the second leading cause of death for males, yet studies show that nearly half of men over age 50 are not screened annually for the disease.

In observance of Prostate Cancer Awareness Month, the Germantown office of UT Medical Group Inc. hosted a seminar on Sept. 29 to educate men about the importance of screening and promising new treatments for the disease.

“Unfortunately, early prostate cancer has no visible symptoms, and by the time you experience symptoms, the cancer may be at an advanced stage,” said Dr. Ithaar Derweesh, UT Medical Group urologist and assistant professor at the University of Tennessee Health Science Center.

While no single screening test provides 100 percent accuracy, Derweesh said screening does help to reduce deaths from the disease by determining which men may need more invasive testing, such as a biopsy.

Men who are at highest risk for developing the disease include those over age 65, African-Americans, men who have a close male relative with prostate cancer, and males who consume high-fat, high- cholesterol diet.

The prostate-specific antigen (PSA) blood test and the digital rectal examination (DRE) are the most effective tests available for the early detection of prostate cancer. As part of an annual checkup, the American Cancer Society recommends the DRE and PSA test for men 50 and older who have a life expectancy of at least 10 years. If you are in a high-risk group, the ACS recommends that screening begin at age 45.

“About 90 percent of prostate cancers have an elevated PSA, but a high PSA by itself does not necessarily mean you have cancer,” Derweesh explained.

He said the medical community is in the process of changing some of its recommendations to improve the chances of detecting early prostate cancer based on new data. Among those has been revising existing PSA rating guidelines. Until recently, a PSA level of 0 to 4 was considered to be “normal.” Now, most doctors agree that a reading of 0 to 2.5 is normal, while 2.5 to 4 is considered “suspicious.” PSA ratings above 4 are “high.”

“Those changes were made because the data indicate that 25 percent of men with a PSA of 2.5 to 4 have cancer,” Derweesh said. “About 40 to 50 percent of men with a PSA of 4 to 10 have cancer. That goes up to 65 percent if the reading is above 10.”

He noted that doctors are also looking at other ways in which the PSA test can more accurately detect changes in the prostate. Monitoring PSA density and velocity, for instance, may show if the elevated PSA is due to cancer or another medical condition.

If cancer is suspected, Derweesh said the only way to make an accurate diagnosis is remove a tissue sample, or biopsy, of the prostate for further examination. In recent years, the diagnostic accuracy of prostate biopsy has improved, largely due to more comprehensive biopsy protocols and advances such as perfection of local anesthesia technique. Those improvements have made biopsy a much more comfortable 7- to 9-minute office procedure.

The vast research that is being done in the area of prostate cancer has greatly expanded the number of treatment options to patients who are diagnosed with the disease. However, the sheer number of those choices often makes it difficult to make a decision about the best treatment.

“The good news is that we have gotten progressively better at treating prostate cancer and minimizing the side effects of various treatments,” he said. In fact, previous research conducted by Derweesh at Ohio’s Cleveland Clinic showed that outcomes have improved significantly over the past five to 10 years for men who had the same disease stage of prostate cancer.

Derweesh said patients who receive a diagnosis of prostate cancer should arm themselves with knowledge and ask questions.

Joy Sutherland is manager of public relations and publications for UT Medical Group.

Source: Commercial Appeal, The

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