By Virginia ‘Ginya’ Carnahan, APR, CPRC
Dattoli Cancer Center & Brachytherapy Research Institute
Does anyone really need Prostate Cancer Awareness Month? October is just around the corner and the entire nation will be blasted with pink ribbons and every conceivable event and gimmick to hammer home the message about breast cancer. But what about prostate cancer?
It is an interesting question when you look at the statistics. More men are diagnosed with prostate cancer every year than women are diagnosed with breast cancer. Yet somehow the women have coalesced to create what is perhaps the most successful awareness campaign since the March of Dimes to fight polio, established by Franklin Roosevelt in 1943. In so many ways the guys just don’t have it together!
While potentially fatal, prostate cancer generally is not as deadly as breast cancer, but it is nothing to sneeze at either. Untreated prostate cancer can eventually migrate through the man’s body causing many problems along the way, including impotence and incontinence. Both diseases benefit greatly from early diagnosis – which is the main message of the awareness campaigns. So let’s start with the basics, then I’ll add some interesting but questionable information about prostate cancer.
WHAT IS PROSTATE CANCER SCREENING?
Screening for prostate cancer consists of one test and one exam. The PSA blood test requires one small tube of blood, which will be processed in a laboratory to determine if the level of prostatic specific antigen (PSA) is abnormal. A digital rectal exam (DRE) is performed by the doctor to determine if there are any obvious physical abnormalities of the prostate gland. If either or both of the PSA test or DRE exam is abnormal, further evaluation will be advised. The screening will not tell if prostate cancer is present; it will only reveal whether further evaluation is necessary.
WHO SHOULD BE SCREENED?
Any man who is approaching age 50 should have a baseline screening in order to know what is “normal” for him. In addition, any man who has a family history of prostate cancer (father, brother, grandfather, uncle) should have an annual screening, as these men have a
higher risk of developing prostate cancer. African Americans also have an increased risk of prostate cancer and are advised to have an initial screening even younger — perhaps at age 40.
WHAT HAPPENS AFTER
The PSA blood test will be processed in a laboratory and the results will be sent to the man. The results of the DRE will be communicated with the man either at the time of the exam or in a follow-up communication. These results should be made part of the
man’s medical record. Send a copy to your family doctor. If everything is normal, then there is no concern at the moment – but the screening should be repeated annually as things can change rapidly.
WHAT HAPPENS IF THE
SCREENING REVEALS A
If the screening turns up something abnormal the man will be advised to see a doctor (family practitioner, internist or urologist) for further evaluation. If the PSA is elevated, it might be repeated after a couple of weeks.
There are things that can cause the PSA to rise that are not cancer related.
Some men have chronic prostatitis, which is an infection or inflammation of the prostate gland. The doctor often prescribes a course of antibiotics to knock out the infection, then orders a follow-up PSA test. The PSA can also rise based on activities prior to the blood test. Men who have ridden a bicycle, motorcycle or a horse within 24-48 hours of having the blood test can find that their PSA was elevated because of the pressure being put on the perineum (the space between the testicles and the rectum). Also, having intercourse 24-48 hours before the PSA test can drive the level up. Unfortunately many men are not aware that these things can affect the outcome of screenings.
If the digital rectal exam is abnormal, having a second physician repeat the exam will be helpful. DRE’s are subjective based on the experience and sensitivity of the physician performing the exam. One doctor may find the gland to be normal while another, more experienced doctor may find an abnormality.
After both the PSA and DRE are reviewed and perhaps redone, if there are still abnormalities the physician may recommend a biopsy of the gland. The biopsy is the only way to determine if cancer is present. (This is true for all types of cancers.) The pros and cons of having a biopsy will be discussed with the patient. The decision to have a biopsy should be made with full understanding of the risks and benefits of taking this step. Remember – like all other cancers, prostate cancer is best treated when found early and that is why we recommend annual screening.
So now if you are wavering on the fence about whether to take advantage of Prostate Cancer Awareness Month free events, here is some recently published questionable information about your risks for prostate cancer:
According to a British study having an index finger shorter than your ring finger could increase your risk of prostate cancer, particularly in men under 60 years. They say finger length correlates with exposure to testosterone before birth and that could affect risk of cancer in later life.
A study published in Cancer Epidemiology, Biomarkers & Prevention found that men with any type of baldness had a 69% greater risk of prostate cancer, and young men with frontal hair loss were six times as likely as those without such baldness to be diagnosed with advanced prostate cancer by age 60.
A couple of studies done in the United Kingdom and the U.S. looked at men with and without prostate cancer and found that the tallest of these men had a 19% higher risk of developing prostate cancer than the shortest men. Men over six feet tall had the highest risk and findings showed that men over 6’3” and under the age of sixty-five had an even higher risk of aggressive prostate cancer.
LIVING IN THE NORTH
The Prostate Cancer Foundation found that men who live north of 40 degrees latitude (north of such cities as Philadelphia, Indianapolis and Denver, for example) have the highest risk of dying from prostate cancer compared to other men in the U.S. It could be that men in colder places have lower vitamin D (the sunshine vitamin) levels. We do know that vitamin D is important to prostate health.
All this goes to underscore how much research continues into trying to understand what causes prostate cancer, how to prevent it, who is most at risk, how to diagnose it and most importantly what to do if you find that you have it.
So if you are an early balding, tall man who has lived in the north and your index finger is short, YOU are the man who should be in line first for the FREE Prostate Cancer Screening offered at Dattoli Cancer Center on Saturday, September 12. This is the 15th year that the non-for-profit Dattoli Cancer Foundation has offered this community service. The event will run from 10:00 am until 2:00 pm. It is first-come, first-served … no appointments. It is not necessary to fast before the test. The Dattoli Cancer Center is located at 2803 Fruitville Road, in the Pen West Office Complex at the corner of Tuttle Avenue.
For information or questions BEFORE the day of the event, please call 941-365-5599.
1-877-DATTOLI | www.dattoli.com