Men diagnosed with prostate cancer can be overwhelmed with the decisions, treatment options, and not knowing what the future holds. To defeat the second leading cause of cancer death in American men behind only lung cancer, men need to arm themselves with adequate knowledge of what exactly prostate cancer is. Dr. David Samadi explains in order to fight prostate cancer the first step is to understand it.
A diagnosis of prostate cancer is not only upsetting for a man but if his knowledge of prostate cancer is limited, this can possibly set him on the wrong track of knowing how best to fight it.
“You have prostate cancer is the last thing any man wants to hear from his doctor,” says Dr. David Samadi. “Men come in scared not completely understanding what prostate cancer means. I have always firmly believed the more a man can learn and figure out what he is dealing with, the more he can take charge of his health condition vastly improving his chances of coming out okay in the end.”
The prostate is a gland found only in men and is a part of the male reproductive system. Its function is to produce a fluid that contributes to the formation of semen. Sperm, from the testes, is mixed with the fluids from the prostate along with fluid from the seminal vesicles to help support and nourish the sperm so they can live for a period of time after ejaculation.
“In the patients I’ve seen with prostate cancer, the men who have a more clear understanding of the prostate gland and the cancer itself, tend to be willing to take the necessary steps to eliminate it and have more trust in me and themselves,” explained Dr. Samadi.
Prostate cancer is when cells in the prostate gland grow uncontrollably. The prostate sits below the bladder and in front of the rectum. Normally the size of a walnut in younger men, the prostate can grow much larger as a man ages. This enlargement is known as benign prostatic hypertrophy (BPH). BPH can be treated with medicines to shrink the size of the prostate or help it relax to improve urinary flow.
Sometimes another procedure called transurethral resection of the prostate (TURP) may be performed to remove prostate tissue surrounding the urethra to allow ease of the flow of urine.
There can be possible pre-cancerous conditions of the prostate and some research suggests that prostate cancer starts out as a pre-cancerous condition. A prostate biopsy may find these conditions which are called prostatic intraepithelial neoplasia (PIN). They are divided into low-grade PIN in which the patterns of prostate cells appear almost natural or high-grade PIN where the patterns of cells look more abnormal. Low-grade PIN can develop in some men as early as their 20’s but the link between low-grade PIN and prostate cancer is still unclear. High-grade PIN has about a 20 percent change of there being cancer in another area of the prostate.
Approximately 240,000 new cases of prostate cancer will be diagnosed in 2016 and it is the most common cancer diagnosis in men in the United States. About 1 in 6 men will be diagnosed with this disease over his lifetime. Up to 30,000 men die annually in the U.S from prostate cancer but if caught early, there is up to a 90% cure rate.
The best defense is to have a game plan of good offense when it comes to prostate cancer.
“Women are very good about getting yearly checkups. Men need to do the same and have yearly exams to assess what is going on with their prostate. A simple rectal exam which takes less than a minute and a yearly PSA blood test starting at age 40 are good screening tools urologists use to detect any changes in the prostate gland.” Said Dr. Samadi. “Not getting screened is unwise and a man will be missing his opportunity to catch any changes before it’s too late.”
Depending on the outcome of the rectal exam and PSA blood test, will determine what the next steps are. While the PSA test and rectal exam are not perfect, when performed regularly, they still remain the best way to detect prostate cancer.
If abnormalities are found with either the rectal exam or the PSA test, from there the doctor may decide to do a prostate biopsy in which a urologist obtains tissue samples from the prostate gland. Those samples of tissue are sent to a pathologist to screen the size, shape, and pattern of growth of possible cancer cells and will assign what is called a Gleason score. The Gleason score is used to describe the aggressiveness of the cancer cells and to predict prognosis and to determine what therapy is best for the patient.
Once the initial diagnostic findings (PSA, Gleason score, rectal exam) are sorted out, from there it will be determined if further imaging tests are required. The imaging tests could be use of a computed tomography (CT) scan used to determine if cancer has spread outside of the prostate, particularly to the lymph nodes. Magnetic Resonance Imaging (MRI) is another imaging test using strong magnets to look for cancer that has spread through the edge of the prostate.
After any imaging testing is completed from there treatment options will be decided depending on what stage the cancer is in. One option a man and his doctor may decide to do is called active surveillance. This is the decision not to treat prostate cancer at the time of diagnosis based on the man’s age, health condition and the rate of growth of the cancer.
If the cancer needs to be treated more aggressively, there are several methods of therapy to consider, all depending again on each individual man’s prostate cancer, the expected rate of growth, staging and other factors. The doctor may decide to choose one type of therapy or a combination to beat back the cancer. His choices range from the da Vinci prostatectomy, radiation therapy, Cyberknife SBRT procedure, IMRT procedure, seed implant procedure, or hormone therapy.
“All men need to be familiar with their bodies and know signs and symptoms when something doesn’t seem right,” said Dr. Samadi. “But with prostate cancer there often may not be many symptoms or they seem vague and unimportant. Be your own health advocate. The best way to fight off this potential killer is to get regular checkups, understand the prostate and prostate cancer and find a urologist who will guide you through the battle every step of the way.”
Patients newly diagnosed with prostate cancer can contact world renowned prostate cancer surgeon and urologic oncologist, Dr. David Samadi, for a free phone consultation and to learn more about prostate cancer risk, call 212-365-5000.