In Iowa in 2013, 350 men will die from prostate cancer. Nationally, the number is nearly 30,000. These numbers come from a cancer that if caught early, has a five-year survival rate that approaches 100 percent. Prostate cancer develops in a man's prostate, the walnut-sized gland just below the bladder that produces some of the fluid in semen. It's the most common cancer in men after skin cancer. Prostate cancer often grows very slowly and may not cause significant harm.
But some types are more aggressive and can spread quickly without treatment.
Prostate cancer is the most common cancer in American men, and in most men it grows very slowly. Growing older is the greatest risk factor for prostate cancer, particularly after age 50. As men age, the chance of finding abnormal cells on a biopsy that look cancerous increases, most of those will not progress to actual cancer. The medical profession is working to find other tests that more accurately predict which men need treatment. Family history increases a man's risk: having a father or brother with prostate cancer doubles the risk. African-Americans are at high risk and have the highest rate of prostate cancer in the world. Problems with prostate cancer include the fact that early prostate cancer usually has no symptoms, and the only well-established risk factors for prostate cancer are increasing age, African ancestry, and a family history of the disease. About 60 percent of all prostate cancer cases are diagnosed in men 65 years of age and older, and 97 percent occur in men 50 and older.
At this time, there are insufficient data to recommend for or against routine testing for early prostate cancer detection with the PSA test. The American Cancer Society recommends that beginning at age 50, men who are at average risk of prostate cancer and have a life expectancy of at least 10 years receive information about the potential benefits and known limitations associated with testing for early prostate cancer detection and have an opportunity to make an informed decision about testing. Men at high risk of developing prostate cancer (African-Americans or men with a close relative diagnosed with prostate cancer before age 65) should have this discussion with their health care provider beginning at age 45. Men at even higher risk (because they have several close relatives diagnosed with prostate cancer at an early age) should have this discussion with their provider at age 40. All men should be given sufficient information about the benefits and limitations of testing and early detection to allow them to make a decision based on their personal values and preferences.
"I never miss the opportunity to talk to my doctor about prostate cancer," said Joel Greer, past chair of the American Cancer Society's Iowa Advisory Board. "Knowing prostate cancer is the most common cancer for men in America, and knowing that if caught early, there's nearly a 100 percent survival rate, I encourage all men to talk to their doctor and stay on top of their prostate health."
The majority (93 percent) of prostate cancers are discovered in the local or regional stages, for which the five-year relative survival rate approaches 100 percent. Over the past 25 years, the five-year relative survival rate for all stages combined has increased from 68 percent to almost 100 percent. According to the most recent data, 10- and 15-year relative survival rates are 98 percent and 93 percent, respectively. Obesity and smoking are associated with an increased risk of dying from prostate cancer.
Symptoms of prostate cancer
In the early stages, men may have no symptoms. Later, symptoms can include:
Frequent urination, especially at night.
Difficulty starting or stopping urination.
Weak or interrupted urinary stream.
Painful or burning sensation during urination or ejaculation.
Blood in urine or semen
Advanced cancer can cause deep pain in the lower back, hips, or upper thighs.
Other diseases can also cause many of these same symptoms. It is important to tell your doctor if you have any of these problems so that the cause can be found and treated, if needed.
If you're living with prostate cancer, you may be able to live longer and healthier by making some changes to your eating and exercise routine. Increasingly, studies show that healthy eating and maintaining an active lifestyle after a prostate cancer diagnosis can lower the chances of the cancer coming back, and can improve the chances of staying disease-free. Healthy habits, such as not smoking, can also improve survival. Benefits may also include a lowered risk of heart disease.
Diet, exercise, smoking and other lifestyle choices you make all impact your overall health and your risk for all cancers. To help you stay well, the American Cancer Society offers the Healthy Living Newsletter, a free monthly email with useful information on eating right, staying active, and other steps you can take to help reduce your cancer risk. Log onto www.cancer.org and sign up for this newsletter to help you stay motivated this coming year.
As the nation's largest nongovernmental investor in cancer research, contributing about $3.4 billion, ACS turns what it knows about cancer into what it does. As a result, more than 11 million people in America who have had cancer and countless more who have avoided it will be celebrating birthdays this year. For more information about prostate cancer, please visit www.cancer.org or call (800) 227-2345. To enroll in the Fort Dodge Cancer Prevention Study-3, please sign up at www.cps3fortdodge.org
Dr. Randy Minion is a physician with UnityPoint Clinic Family Medicine Kenyon Road.
Liddy Hora is the American Cancer Society hospital representative and can be reached at firstname.lastname@example.org.