September is Prostate Cancer Awareness Month

Prostate Cancer is the most common cancer in men. Because September is Prostate Cancer Awareness Month MPB's Karen Brown spoke with Dr. Charles Pound, Associate Professor and Chief, Division of Urology (UMC), about its risk factors, symptoms and treatment.

Karen: What are the risk factors and who is most susceptible to prostate cancer?

Dr. Pound: Risk factors at this point are age, family history and your race. Certainly as a man ages his risk for developing prostate cancer goes up dramatically. And that’s why as men get older we encourage them to undergo regular screening for prostate cancer. Having a first degree relative with prostate cancer also increases your risk of developing a cancer not quite twofold but almost twofold. And with each other first degree relative with prostate cancer your risk goes up even more. At least within the United States, African Americans have the highest risk with Caucasians second and people of Asian descent have a less likelihood of developing prostate cancer.

Karen: Are there specific symptoms to prostate cancer?

Dr. Pound: Generally not. If a patient has developed symptoms, most often that’s bleeding or difficulty with urination and those are generally what we call advanced cancers or cancers that have already gotten beyond the curable stage. Most cancers that are diagnosed are completely asymptomatic. They’re diagnosed 80 to 90 percent of the time based upon some abnormal blood work – the prostate specific antigen or the psa that’s done once a year. In most instances the patient is completely asymptomatic.

Karen: At what age should a man have that first screening and then how often after that?

Dr. Pound: It depends on who you ask. If you ask a urologist or the American association of urology or the American Urological association they will tell you what I believe is that certainly African American men should start at the age of 40 but even Caucasian men, in their early 40s, should have a baseline psa done and if that is abnormal, follow it yearly or if it is normal consider having it done two or three times in that decade between 40 and fifty. But over the age of 50 everyone believes that it’s something a man should have done once a year when they have their regular visit.

Karen: Because this is Prostate Cancer Awareness Month many hospitals and physicians offering screenings, free screenings in some cases. What does a screening entail?

Dr. Pound: Most screenings involve both the blood work that we discussed and a physical exam, when the doctor will actually examine the prostate with what’s called a digital rectal exam. Some screenings done on a large scale may be just the blood work because they just don’t have enough volunteers or personnel to examine all the screening participants and if that’s the case, the blood work is good, the blood work is important but it’s important for people to realize that it’s important to have a physical examination done by their regular doctor. The other thing people need to do with screening is make sure that if you’re not doing it in your regular doctor’s office save the results of your blood work from year to year because even if your blood work is normal it’s important for your doctor to be able to look at the trend of your psa over the last few years. Sometimes people with blood work in the normal range may still have a cancer in that the only reason to tell that is that their blood work has gone up year after year.

Karen: Talk about the treatment options.

Dr. Pound: There are a wide variety of treatment options from surgical removal of the prostate to radiation therapy of the prostate both with, what we call radioactive seeds or Brachytherapy or external beam radiation. Also, for some older people, medical treatment without radiation or surgery may sometimes be appropriate. Sometimes these are the types of cancers that we don’t have to treat; that we don’t think pose a threat to someone’s long term survival and in that case we just keep an eye on it year after year to monitor it and make sure it isn’t growing and becoming more serious.

Karen: But generally the prognosis is pretty good for someone who’s diagnosed with prostate cancer?

Dr. Pound: Absolutely. If it’s caught early when its’ still within the prostate with a variety of treatment options men have a very good outcome for living a natural life with a minimal amount of side effects from treatment.