| A University of Michigan Health Minute update on important health
issues
originally posted September 12, 2000
ANN ARBOR, Mich. - This year, about 170,000
American men will learn they have prostate cancer. Because
there are usually no symptoms in early stages of the disease,
regular check-ups and early detection are the best weapons
against prostate cancer - the leading cause of cancer in men.
Prostate cancer is a serious health problem, but there's good
news to report, says Martin Sanda, M.D., a urological oncologist
in the University
of Michigan Comprehensive Cancer Center. "Ten to 15 years
ago, many men were diagnosed too late to offer them a cure.
Today, patients are being diagnosed earlier with less advanced
cancer when they have an outstanding chance of being completely
cured with their first treatment," says Sanda. In a recent
study of prostate cancer patients, Sanda found that more than
99 percent of men diagnosed with low-grade or intermediate-grade
cancers who had favorable pre-treatment PSA screening test
results were free of any sign of spread or re-occurrence five
years after treatment. A simple two-part screening test --
performed in your physician's office - is the key to early
diagnosis of prostate cancer. The first part is an annual
digital rectal exam - recommended for all men over age 40.
In this painless exam, a doctor will insert a gloved finger
in your rectum to feel any lumps or abnormalities in the prostate
gland. The second life-saving screening exam is a blood test
for PSA - a substance called prostate specific antigen - which
is produced by the prostate gland. An abnormally high PSA
level is a warning sign for cancer, although infection or
other conditions can cause high PSA levels, too. "We recommend
PSA screening for healthy men after age 50," says Sanda. "Men
with an increased risk of prostate cancer, which includes
African-American men and any men with a family history of
prostate cancer, should have their PSA levels tested at age
40 or 45." If screening test results are suspicious, your
doctor may recommend that you see a urologist for consideration
of a prostate biopsy. A biopsy is the only way to confirm
whether you have cancer. It is a simple outpatient procedure
routinely performed in a doctor's office. - more - Prostate
Cancer - 2 If you are diagnosed with prostate cancer, Sanda
says your doctor will explain the treatment options available
to you, depending on your age and type of cancer. "These include
either surgical removal of the prostate gland or radiation
therapy or implantation of radioactive seeds in the prostate,"
he explains. "Moreover, some slower growing types of prostate
cancer can be monitored and treatment deferred." According
to Sanda, the University of Michigan Comprehensive Cancer
Center is looking for patients to participate in a large clinical
trial comparing the side effects of different types of prostate
cancer therapies. "This is a very important study to help
physicians determine what treatments are most appropriate
for which patients," explains Sanda. It's important not to
let fear of side effects, such as urinary incontinence and
impotence, prevent men from being screened or treated for
prostate cancer, adds Sanda. "This is an appropriate concern
for patients, but there have been significant advances in
surgical and radiation treatment. Patients now have a much
lower risk of long-term side effects than has traditionally
been the case." In fact, a recent study by Sanda and other
U-M scientists found that meticulous nerve-sparing technique
during a radical prostatectomy procedure reduced long-term
incontinence rates by half when compared with traditional
surgical techniques. "This technique reduces the percentage
of men with significant long-term incontinence to less than
5 percent," says Sanda. "But not all patients need to immediately
be treated for prostate cancer," emphasizes Sanda. "Patients
should discuss the timing of treatment with their physician
to develop a plan that's suitable for them, their family and
their doctor." Facts about prostate cancer: · Curable prostate
cancers usually cause no symptoms, so screening is essential
for detection. · Although age is a risk factor for prostate
cancer, the disease is more dangerous in men in their 50s
and early 60s than in older men. This is why it is so important
for men to begin screening before the age of 60. Prostate
cancer in older men is often a slower growing and less dangerous
variety. · A family history of prostate cancer on either the
father's or mother's side increases your risk of developing
the disease. · African-American men have twice the risk of
developing prostate cancer as Caucasian men. The disease is
most common in North America and northern Europe. · Prostate
cancer is more common in regions with lower exposure to sunlight,
such as Michigan, and in regions where diets are high in fat.
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