By William C. Carter, MD, Lowcountry Urology Clinics
September is Prostate Cancer awareness month. Why is this annual observation needed? Because it cannot be restated enough to men and to the people who care about them that prostate cancer is the most common cause of cancer-related death among American males. It is also the perfect time to let people know that prostate cancer can be detected with a test that could save your life.
This year alone, prostate cancer will kill an estimated 30,000 men in the US and 250,000 worldwide. Over the past 20 years the incidence of prostate cancer has gradually increased and now affects one in every six American men.
Today, there are more cases of the disease but fewer men are dying from it. In the past decade the mortality rate has decreased by 40 percent.
The Prostate Cancer Foundation and the American Urology Association (AUA) believe that detection through what is called a prostate specific antigen (PSA) screening is responsible for saving many of those lives, and I agree.
There is some controversy regarding PSA screening, and while no science is perfect, there is a significant amount of evidence to support the validity of the test.
What do we know?
• Prior to PSA screening, 25 percent of patients with newly diagnosed prostate cancer already had spread of the cancer and were not curable;
• Today with PSA screening, only 4 percent of men diagnosed with prostate cancer have spread of the cancer at the time of diagnosis;
• In Great Britain where PSA screening is not utilized, 50 percent of men diagnosed with prostate cancer will survive 5 years;
• In the US, with PSA screening, 90 percent of men survive 10 years;
• In a study performed at Roper Hospital the number of patients who underwent surgery to remove a cancerous prostate in the pre-PSA years had a 25 percent probability of local spread of the cancer. Today, with PSA screening the number of men who have local spread of cancer at the time of surgery is less than five percent;
• With PSA screening we are able to improve the survival rate of patients with prostate cancer and avoid unnecessary treatment in some patients with very early stage prostate cancer;
• The men who are at highest risk for developing prostate cancer should be followed very closely. This group includes African Americans and men with a family history of prostate cancer.
Can prostate cancer be prevented? Not totally, but there are factors that can decrease the probability of developing it. Genetics play an important role, but there are also some controllable factors including:
• Obesity. Obese men have an increased risk of prostate cancer, colon cancer, breast cancer, diabetes and heart disease.
• Exercise. It lowers the risk of prostate cancer and improves erectile function. The combination of increased body fat and lack of exercise increases the probability for aggressive prostate cancer.
• Diet. Whole grains, fruits, vegetables and reducing animal fat intake decrease the risk of prostate cancer.
When should men get tested? The AUA says to get the first PSA screening at age 40, the second at 45 and the third at 50. If levels are still healthy, the AUA recommends repeating the test annually until age 75.
Join us for a Men's Health Night aboard the USS Yorktown on Sept. 27 to learn more about good men's health. Registration is required by calling 843-402-CARE.
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