Early Screening: His Best Ally

From the Fall 2011 StayHealthy publication

“While prostate cancer is the most common cancer in American men, not counting skin cancer, there’s no reason to die of prostate cancer,” said John Lynam, DO, urologist with Lakeshore Urology. “The vast majority of prostate cancer is completely curable if caught early, which is why early screening is your best ally.”*

According to Lynam, early screening is especially important in detecting prostate cancer, which rarely exhibits symptoms. “That’s the thing, often there really are no symptoms of prostate cancer. Nothing you’d notice. Without screening, prostate cancer can progress relatively undetected until it’s widespread throughout the body. Yet screening is so simple,” said Lynam.

What is Prostate Screening?
Screening for prostate cancer involves two simple steps. First, a blood test detects the level of a protein called prostate specific antigen or PSA. Elevated levels of PSA indicate the need for further testing, said Lynam. The second part of screening is a brief digital rectal exam to detect nodules, bumps, asymmetry or other irregularity.

Who needs screening?
“I recommend that patients begin screening annually for prostate cancer at age 40, unless there is an immediate family member – a father or brother – who was diagnosed with prostate cancer,” Lynam said, in which case screening may need to begin earlier. According to Lynam, your doctor can help you decide when to begin screening. “Nothing really predisposes you to have a higher risk for prostate cancer other than genetics. Prostate problems aren’t related to smoking or drinking or other behaviors,” he said, “although African American men genetically tend to have higher incidence of prostate cancer at earlier ages, and higher mortality rates.”

So, if screening begins at age 40, how long is it important? “Any man with a greater than 10-year life expectancy should continue screening,” said Lynam. “After the age of 80, men may die with prostate cancer, but not from it as it’s slow-growing in older men. If diagnosed in younger men, it tends to be a more aggressive strain. In fact, at the advanced age of 80, most men have some degree of prostate cancer. So the longer your life expectancy, the more important it is to find prostate cancer early,” he said.

What if they find something?
An irregular finding or an elevated PSA don’t necessarily mean a diagnosis of prostate cancer, but it may reveal a risk profile that warrants further testing, said Lynam. “If the PSA is elevated or a digital exam is concerning, we’ll follow with a prostate biopsy, which is done in the office,” he said. Using an ultrasound and local anesthesia, samples are taken for examination by a pathologist to diagnose any malignancy.

Optimism in Treatment
“Prostate cancer is very treatable when found early. There are many intervention options,” he said. “Treatments may include hormone therapy, outpatient radiation or placement of radioactive ‘seeds,’” said Lynam. Surgical options include minimally invasive procedures using the daVinci robot or traditional open surgery at Porter. “Hormone therapy is also an option for certain patients. Though it’s not curative, it can be an effective treatment to slow progression of the disease. We may use a combination of treatments or even just watchful waiting in certain cases where the cancer is detected early and determined to be nonaggressive,” he said.

“It’s true that we’re finding more prostate cancer these days, but I believe that’s largely because we’re screening better. We’re finding it sooner, giving patients the best chances for a cure,” he said. “And when you find it early, prostate cancer isn’t the end of the world, but the beginning of treatment.”

What is the prostate?

The prostate is part of a man’s reproductive system. The prostate gland is the size of a walnut and is located in front of the rectum and wraps around the tube that carries urine from the bladder. As men age they have a greater risk of developing prostate cancer as well as an enlarged prostate, a condition called benign prostatic hyperplasia (BPH). While there are really no symptoms for prostate cancer, symptoms of BPH include frequent urination, straining to urinate, a weak urine stream or a sensation that the bladder has not completely emptied.

*Source American Cancer Society