National Prostate Cancer Awareness Month focuses attention on the disease and ways for men to safeguard their health. Aside from skin cancer, prostate cancer is the most common cancer in men. Often, there are no early symptoms.

Risk Factors

Age is the biggest risk factor for prostate cancer, particularly for men over 50. Family history also increases their risks. African-American men and Caribbean men of African descent have the highest rate of prostate cancer. Louisiana has among the highest incidence rates in the country.

Diet seems to play a role in prostate cancer, which occurs more frequently in countries with high meat and high-fat dairy diets. American Cancer Society guidelines recommend limiting processed and red meats and eating at least 2.5 cups of fruits and vegetables a day to reduce cancer risks.

Symptoms

Prostate cancer often grows slowly. In more advanced stages, symptoms can include:

• Frequent urination, especially at night;
• Difficulty starting or stopping urination;
• Weak or interrupted urinary stream;
• Painful or burning sensation during urination or ejaculation;
• Blood in urine or semen;
• Deep pain in the lower back, hips, or upper thighs.

Screenings

The American Cancer Society advises men to talk with their doctors about screening tests beginning at:

• Age 50 for average-risk men who expect to live at least 10 more years;
• Age 45 for men at high risk, including African-Americans and men with a father, brother, or son diagnosed before age 65;
• Age 40 for men with more than one first-degree relative diagnosed at early ages.

Doctors may perform digital rectal exams to feel for bumps or hard spots on the prostate and blood tests to measure prostate-specific antigen (PSA), a protein produced by prostate cells.

A normal PSA level is considered to be under 4, while a PSA above 10 suggests a high risk of cancer. But there are exceptions, as men with lower PSA levels can have cancer. Prostates that are inflamed (prostatitis) or enlarged (BPH) can also increase PSA levels.

Biopsies and Staging

If tests indicate a problem, the doctor may recommend a biopsy. When cancer is detected, additional imaging such as ultrasounds, CT scans, or MRI scans help in “staging” the cancer or determining how far it has spread (metastasized).

• Stage I: Small and still within the prostate;
• Stage II: More advanced but confined to the prostate;
• Stage III: May have spread beyond the prostate or into nearby tissues;
• Stage IV: Has spread to lymph nodes or organs such as bones or lungs.

Survival Rates

According to the American Cancer Society, after lung cancer, prostate cancer is the second leading cause of cancer death in American men. However, the five-year survival rate is 100 percent when the disease is confined to the prostate or nearby tissues. When it spreads to distant organs, that drops to 29 percent.

Treatments

When the case is low-risk cancer, doctors may advise patients to watch and wait. Otherwise, prostate cancer treatment options include surgery, chemotherapy, hormonal therapy, and/or radiation.

Side effects that seem to concern men the most include impotence, urinary impairment and erectile dysfunction. However, newer surgical techniques help minimize damage to nearby nerves. Also, there are a number of medications and other treatments for improving erectile function.

Laura Gros, RN, CBCN is the Patient Care Coordinator of the Thibodaux Regional Medical Center’s Cancer Center. For more information contact the Cancer Center at TRMC at 985.493.4008.