Men should discuss prostate cancer risks with their healthcare providers

Parkland physician stresses importance of early detection

DALLAS – Prostate cancer is the second leading cause of cancer death in men in the United States, behind lung cancer. According to the American Cancer Society, 1 in 9 men will be diagnosed with prostate cancer during his lifetime and nearly 175,000 new cases of prostate cancer will be detected in 2019. Though potentially serious, in most cases it can be successfully treated, especially if detected early. National Prostate Cancer Awareness Month each September offers men the opportunity to learn more about the disease, risk factors and possible treatments.

“We want our patients to seek information about this form of cancer and be aware that screenings could help save their lives,” said Yair Lotan, MD, Medical Director of the Urology Clinic at Parkland Health & Hospital System and Professor of Urology at UT Southwestern Medical Center.

In many cases, prostate cancer is slow growing, and often people who suffer from it don’t show symptoms. “The vast majority of men are diagnosed when they have no symptoms and although urinary symptoms can occur, they are not common. That’s why screenings are important,” Dr. Lotan said.

Prostate cancer can often be found early by performing a prostate-specific antigen (PSA) blood test and a digital rectal exam. If these exams suggest the possibility of cancer being present, providers perform other exams, such as a transrectal ultrasound guided prostate biopsy to confirm the diagnosis.

Age is the strongest factor for developing prostate cancer, with about two-thirds of the cases being diagnosed in men 65 and older. But family history, and even race, can also play a role. African-American men are disproportionally affected by the disease, having higher rates of prostate cancer diagnosis and death than men of all other racial or ethnic groups in the U.S.

“Researchers still aren’t sure why race may be a factor,” Dr. Lotan said.

Symptoms of prostate cancer vary widely and most men have no symptoms. Those who do may experience difficulty in starting urination; weak or interrupted flow of urine; frequent urination, especially at night; pain or burn during urination; blood in the urine or semen; or pain in the back, hips or pelvis that doesn’t go away.

Dr. Lotan noted that while discussing prostate cancer with your doctor is important, not all medical experts agree that the benefits of screening for prostate cancer outweigh the risks.

“The U.S. Preventive Services Task Force recommends against prostate-specific antigen (PSA)-based screening for men unless the individual being screened understands what is known about PSA screening and makes the personal decision that even a small possibility of benefit outweighs the known risks,” Dr. Lotan said. “Patients should have an open and honest conversation with their providers to discuss the risks, uncertainties and possible benefits of screening procedures.”

“The good news is that most men who are appropriately screened are diagnosed with curable disease. Also, some men are found to have non-aggressive disease and don’t need treatment and can just be monitored,” Dr. Lotan said.

Men diagnosed with prostate cancer should consult with their physicians and carefully weigh a number of factors before making a treatment decision. Factors to consider include age, expected life span, other health conditions and stage of cancer. Treatment options include active surveillance, surgery, radiation, chemotherapy and cryosurgery.

For more information on prostate cancer, visit the American Cancer Society at www.cancer.org. Men needing to discuss prostate cancer with a physician can contact any of Parkland’s Community Oriented Primary Care health centers, which can be located by visiting www.parklandhospital.com/phhs/locations.