What every man should know about prostate cancer

Having a healthy prostate is important because it affects both sexual and urinary functions. But many men tend to put off regular health checkups and screenings — particularly when it comes to prostate cancer.

The prostate gland is about the size of a walnut and sits just below the bladder and in front of the rectum. Its primary function is to produce the liquid that transports sperm.

According to Dr. David Bodkin, a board-certified oncologist affiliated with Sharp Grossmont Hospital, “prostate cancer is the second-leading cause of cancer-related death in men after lung cancer, and 1 in 8 men will develop it in their lifetime.”

He adds, “As with most cancers, when prostate cancer is caught early, it’s easier to treat and the chances for survival are good.”

Sharp recommends that men at average risk begin screening at age 50 with an initial prostate exam during their physical, along with a discussion of personal and family health history, and then continue screening annually. Depending on personal risk factors, or for men who are at higher risk, screening is recommended starting at age 45.

Although screening can help detect symptoms before they start, Dr. Bodkin advises that it’s important for men to talk to their doctor about the pros and cons of screening and what’s right for them.

A growing number of experts feel that prostate cancer is slow-growing, and many men who have it may never develop cancer or even know they have the disease until they’re screened. That’s because the test used, a prostate-specific antigen (PSA) blood test, alerts doctors to the presence of cancer, but there’s no definitive way to determine whether it would have ever caused symptoms or harm.

Therefore, the benefits and disadvantages of treatment should be weighed carefully. Dr. Bodkin answers seven common questions about prostate cancer:

1. What are the symptoms of prostate cancer?
   Symptoms include weak urine flow, decreased sexual function, painful urination, frequent nighttime urination, and presence of blood in the urine or semen. However, in some instances, there are no symptoms at all, which is why screening is important.

2. What are the risk factors?
   The most common risk factor is age. The older a man is, the greater the chance of getting prostate cancer. Also, men who have a family history of prostate cancer are at higher risk.

3. What is watchful waiting?
   Because prostate cancer often grows very slowly, some men — particularly those who are older or have other serious health problems — don’t receive treatment and opt for observation. This is known as watchful waiting. Another term used is active surveillance, which usually includes regular monitoring, follow-up doctor visits and testing at regular intervals. It’s important to note that more than 50% of new diagnoses are of low level to spread.

4. What is a PSA blood test?
   A prostate-specific antigen (PSA) blood test measures the level of a protein called prostate-specific antigen, which is made by cells in the prostate. The chance of having prostate cancer goes up as the PSA level goes up, but there is no set cutoff point that can tell for sure if a man does or doesn’t have prostate cancer. If your PSA level is high, you might need further tests to look for prostate cancer.

5. How is prostate cancer treated?
   When a biopsy is done and reveals cancer, a pathologist provides information such as aggressiveness, extent of invasion, grade and other details that factor into treatment options. A few common options include watchful waiting, active surveillance, surgery, and radiation therapy. For higher stage disease, treatment may involve targeted and systemic therapies, including hormonal therapy or chemotherapy, as well as immunotherapy.

6. Are there any lifestyle changes, such as diet or exercise, that could help reduce risk?
   Eating a balanced diet that includes plenty of fruits and vegetables; avoiding or limiting red and processed meats and fatty foods; and keeping physically active to maintain a healthy weight.

7. Are there any new advancements in the detection of prostate cancer?
   Analysis of pathology has changed and become more sophisticated. It is now more than a pathologist looking at a biopsy. The specimen can be sent for analysis of genes — both inherited and acquired mutations in DNA — that have prognostic value.

Learn more about prostate cancer care at Sharp.

For the news media: To talk with Dr. David Bodkin, board-certified oncologist, about prostate cancer for an upcoming story, contact Erica Carlson, senior public relations specialist, at erica.carlson@sharp.com.