It wouldn’t be right not to talk about prostate cancer, a
disease that only affects men, especially during November while it’s Men’s
Health Awareness Month.
In 2016, more than 180,890 men will be diagnosed with
prostate cancer, the second leading cause of cancer death in men. Next
to skin cancer, prostate cancer is the most common cancer in American men.
“Men’s health and prostate cancer are topics that many tend
to shy away from, but they need to be discussed more openly,” said Soroush
Rais-Bahrami, M.D., assistant professor in the University of Alabama atBirmingham Department of Urology and founding member of the UAB Program forPersonalized Prostate Cancer Care. “One out of eight men will be
diagnosed with prostate cancer in his life.”
The prostate is a reproductive gland in men located
between the bladder and the penis. The fluid from the prostate is discharged
into the urethra at the time of ejaculation as part of the semen to nourish and
stabilize sperm for reproductive purposes.
Prevention
Men should begin screening for prostate cancer at age 50.
This can be done during their annual exam with a discussion about prostate
cancer risks factors. A blood test can be done to measure a biomarker called prostate-specific
antigen (PSA) to identify a man’s risk of prostate cancer, along with a
digital rectal exam. Once a blood test shows signs of higher PSA levels, a
tissue biopsy is required to help determine the grade and stage of the prostate
cancer.
“Many men do not know their family history of prostate
cancer because men tend not to talk about their health concerns, even with
children and other family members,” Rais-Bahrami said. “It is important to
discuss family history due to the significantly higher risk for men with a
first-degree relative who has been diagnosed with prostate cancer.”
Signs and Symptoms
Symptoms of prostate cancer are rare, and many men
show no symptoms before being diagnosed. In advanced stages, symptoms may
affect quality of life and may show in one of the following ways:
- Problems urinating or the need to urinate more frequently, especially at night
- Blood in the urine or semen
- Trouble getting an erection
- Pain in the hips, back (spine), chest (ribs), or other areas the cancer may have spread
- Weakness or numbness in the legs or feet
Risk Factors
Some risk factors are controllable and others are not.
According to the American Cancer Society, the following are some risk factors
for prostate cancer:
Age: The chance
of having prostate cancer increases rapidly after the age of 50. About 6 in 10
cases are in men over the age of 65.
Race: Prostate
cancer occurs more often in African American men. African American men are also
twice as likely to die from prostate cancer than white men.
Family History: Having
a father or brother with prostate cancer more than doubles a man’s risk of developing
it. The risk is much higher for men who have several relatives with prostate
cancer.
Other risk factors may include: diet, obesity, smoking,
inflammation, and some sexually transmitted infections.
Treatment
“Treatment
is based on the patient’s overall health and what works best in treating the
patient to ultimately cure the cancer and help the patient preserve an
excellent quality of life,” Rais-Bahrami said.
In the
earliest stages of low-grade prostate cancer, and with the consultation of a
physician, men can opt for active surveillance, which is when the doctor does
not prescribe immediate treatment, but watches the cancer cells closely to
postpone treatment with curative intent, perhaps for years. Other treatment
options include:
- Surgery, which includes removing the entire prostate gland and occasionally regional lymph node tissues
- Radiation therapy, or beams of radiation focused on the prostate
- Hormone therapy, which reduces levels of male hormones to stop them from affecting prostate cancer cells
- High-intensity, focused ultrasound therapy, or high-energy sound waves that destroy cancer cells
- Cryosurgery, or the use of extreme cold temperatures to freeze and kill cancer cells
“Prostate cancer is a treatable disease and can be
cured if caught in early stages,” Rais-Bahrami said. “This is why it is
important to receive routine screenings and have early detection when present.”
To help with personalized care of patients, UAB offers
magnetic resonance imaging and ultrasound fusion-guided biopsy. The image
fusion allows doctors to target a direct tissue sampling of an individual based
on imaging areas of concern that can be tested for prostate cancer.
Current Research
 |
New research for prostate cancer is on the horizon,
including the ongoing search for better biomarkers that indicate the presence
of prostate cancer. At UAB, prostate cancer research is focused on advanced
imaging and biomarker development, and hopes of defining the best way toward
focal therapy of prostate cancer. UAB has become one of two beta sites in the
United States to receive the iSR’obotTM Mona Lisa machine. This machine helps
surgeons diagnose prostate cancer in earlier stages with imaging guidance and
provides precise location mapping to help with targeting cancer cells for treatment.
