Media Contact: Keith.O’Connor@baystatehealth.org, 413-794-7656
SPRINGFIELD – “There is no one size fits all when it comes to prostate cancer screening today. Men need to have a discussion with their primary care doctor about whether screening is good for them, and that will depend somewhat on age, overall health and family history. They also need to discuss what to do when the results come back,” said Dr. James Stewart, chief, Hematology/Oncology at the Baystate Regional Cancer Program.
Today, men have many treatment options for their prostate cancer, including active surveillance, radiation involving the implantation of radioactive “seeds” or external beam therapy, chemotherapy, hormone treatment, and surgery to remove the prostate gland.
“New research suggests that many men diagnosed with non-aggressive forms of prostate cancer do not need treatment. For patients, this can often be a strange concept: having cancer but not having treatment for it. In these cases, careful monitoring, what we refer to as active surveillance, is increasingly being utilized,” said Dr. Kevin Asher of Pioneer Valley Urology in Springfield, who is a member of the medical staff at Baystate Medical Center.
According to the National Cancer Institute (NCI), among American men, prostate cancer is the second most commonly diagnosed cancer and the second-leading cause of cancer deaths in the United States behind only lung cancer.
The exact causes of prostate cancer are unknown, but research indicates that men with certain risk factors – age, race (especially African Americans), and family history – are more likely to develop prostate cancer.
Many men diagnosed with prostate cancer have no symptoms and only learn
about having the disease through screening. Symptoms that could indicate possible
prostate cancer include the urgent need to urinate, hesitancy or slow stream when urinating, and pain or blood during urination. It should be noted, however, that these urinary symptoms are most typically associated with age-related prostate enlargement and not prostate cancer, noted Dr. Asher.
September is Prostate Cancer Awareness Month – a time to educate men about their options in terms of diagnosis and treatment of prostate conditions, so they can make a more informed decision along with their doctor as to what is right for them.
This May, the American Urological Association (AUA) announced new clinical guidelines which recommend that men ages 55 to 69 who are considering prostate cancer screening should ”talk with their doctors about the benefits and harms of testing.” Previous guidelines issued by the AUA recommended that men starting at age 40 get both a digital rectal exam and a prostate-specific antigen (PSA) blood test. The new guidelines are more in line with the United States Preventive Services Task Force (USPSTF), which last year advocated against PSA testing for healthy men, regardless of age, but did not exclude the use of the PSA test for surveillance after diagnosis or treatment of prostate cancer.
”We know that in the past 20 years we have over-diagnosed many men whose slow-growing cancers were discovered through PSA testing, but would never have caused a problem. On the other hand, a lot of men die from prostate cancer, and you want to find these aggressive cancers early enough when you can do something to make a difference,” said Dr. Stewart.
According to Dr. Asher, PSA testing does offers doctors important information about a man’s risk of being diagnosed with prostate cancer – information that is an important part of a man’s health.
“However, an elevated PSA test may lead to invasive procedures such as prostate biopsy and treatment for prostate cancer. These procedures can have significant urinary and sexual side effects. For some men, prostate cancer treatments are life saving, while for others, they may not be necessary at all and may expose an otherwise healthy man to unintended negative consequences. Men need to understand this before they undergo a PSA blood test,” said Dr. Asher.
“While new advances in minimally invasive prostate surgery and targeted forms
of radiation therapy have helped to reduce side effects from prostate cancer treatment,
it is still important for men to be informed that treatment for prostate cancer, in any form, can have a significant impact on male pelvic health. A patient needs to have a frank, honest discussion with his cancer doctor about these issues,” he added.
For more information on the Baystate Regional Cancer Program, visit baystatehealth.com/brcp.