Prostate cancer, a stealthy and dangerous killer, is the second most common cancer and a leading cause of death in American men, according to the American Cancer Society. ACS also estimates that approximately 240,890 men in the United States will be diagnosed with prostate cancer and more than 33,720 deaths are expected this year. In fact, one out of every six men will be diagnosed with prostate cancer during his lifetime.
In recognition of National Prostate Cancer Awareness month, Warren Bromberg, MD, FACS, Chief of Urology and Director of the Prostate Program at Northern Westchester Hospital, answers some questions about prostate cancer.
How often should a middle-aged man see his physician and why is this important? If a man is under 50 and healthy, and there's no history of chronic disease in his family (heart disease or cancer, for example), seeing a doctor every two or three years is probably enough. But if you have high blood pressure, high cholesterol or a first-degree relative (a brother or father) with a serious illness, you should see a doctor at least annually. After 50, annual visits should include a prostate exam with a blood test called prostate-specific antigen, or PSA. For men with a history of prostate cancer in their family, it is particularly important to detect prostate cancer as early as possible.
Regular physical exams can help to identify a number of health issues, prostate cancer being one of them. Why is it so important to catch this early? Prostate cancer is a disease for which there are a number of different treatments, but most are effective only if it's caught before the cancer has spread beyond the prostate gland. Once the cancer escapes the prostate, the chance of cure is markedly diminished. Unfortunately, prostate cancer rarely causes symptoms, so it can grow for years unnoticed. A visit to the doctor is your best bet.
Besides a visit to the doctor, are there other ways to detect prostate problems? Many men will develop urinary problems due a benign condition called BPH which is associated with aging. The slowly enlarging prostate, which encircles the bladder opening, begins to restrict the flow of urine leading to a slow stream, urinary urgency, and nighttime frequency. This affliction can be helped with medication or surgery.
What are the most common treatments for prostate cancer? For men over the age of 75, the most common approach is what we call active observation. Men are regularly checked, but we don't always treat the cancer because it can be slow growing and therefore unlikely to cause problems. If an older man needs treatment, we may suggest radioactive seed implantation. This approach is minimally invasive and can be done under anesthesia in about an hour on an outpatient basis. For younger men, especially those with a faster growing cancer or a family history of the disease, we may advise removing the prostate gland through a robot-assisted laparoscopic prostatectomy. Our results with this procedure have been excellent with low rates of urinary incontinence and erectile dysfunction. Alternatively, in select instances, we recommend seed implantation or external radiation treatment.
Dr. Bromberg says, "A man's greatest advocate for medical care is a woman." He adds, "Spouse, girlfriend, or daughter, women are the driving force in getting men to a checkup, since visiting the doctor usually sits at the bottom of a guy's to-do list, especially when it involves a prostate exam."
"So, remember," says Dr. Bromberg. "Listen to the women in your life and see your doctor for regular exams. It's good for your health!"