What Every Man Needs to Know About Prostate Cancer

The words that a man hears from a doctor indicating that his tests are positive for prostate cancer can, of course, be devastating. There are some basic facts to know about your options that may help you or a loved one cope a bit more easily through this very difficult time.

The prostate is a small gland at the base of the bladder. It is where the fluid part of semen production takes place. According to the American Cancer Society, 1 in 6 men will get cancer of the prostate, and 1 in 33 will die from it. Knowing the treatments and what some of the terms and numbers mean will be essential for the patient.

What causes men to get prostate cancer? The risk factors are wide and can not be concentrated into one age group. A good bottom line is that every male is susceptible. Black men are more likely to get it than Caucasians, and although the risk increases with age, even men in their 40s run a risk. If a close relative had prostate cancer, a man’s risk is higher. Some studies show that heavy intake of animal fat may increase risk and others suggest that intake of soy protein or tomatoes (lycopene) may decrease it.

Experts disagree on when screening should begin, or if it is even necessary at all. Many will advise that age 50 should begin an annual screening, but starting at age 40 or 45 if the higher risk factors (race, family history, etc.) are present. Other experts think that screening beginning at age 40 is a good choice.

A doctor will often be able to recognize the presence of a tumor by a rectal examination, but sometimes the presence of cancer will have to be determined by a blood test, so be prepared to have both of these examinations done.

You will be hearing the term “PSA.” This is the “prostate specific antigen” and is a protein secreted by both normal prostate and prostate cancer cells that can be found in the blood. It tends to be higher in cases where prostate cancer is present. If the blood test or exam indicates that cancer is a possibility, you will be undergoing a biopsy for the next step.

While all this is going on, it is a good idea to ask your doctor about false readings, either false positives or false negatives, on the PSA test. They are indeed possible and they happen — no blood test is perfect to diagnose or exclude cancer — so be sure to know with what you are dealing.

Another good thing to remember is that if you see a list of “symptoms” somewhere, that will not necessarily indicate cancer, either. There are other sorts of prostate problems that can appear. Simply get the testing done to make sure whether you are dealing with cancer or not.

One of the numbers you will be hearing if the diagnosis is indeed cancer is the “stage” that will be given to the tumor. The size of the tumor determines the stage. A cancer will be given a stage of I, II, III, or IV to help determine the extent of the disease and the prognosis. A stage IV cancer has spread to other places in the body while a stage II has no sign of spread.

Still another number that you will be hearing is your Gleason Score. Gleason scores of 6 and below have lower risks of the cancer spreading, and scores of 7 through 10 are increasingly more worrisome the higher the number is for undetected or detectable spread of cancer to other parts of the body. This, of course, affects prognosis and chance of cure. A pathologist will determine your Gleason score and it will be in two parts, such as “3 + 3 = Gleason 6.” Ask your doctor to break those numbers down and explain them to you.

Do not settle for not fully understanding anything concerning your numbers. Ask any questions of your doctor that you need to ask. There will be various treatment options depending on your stage, Gleason Score, etc. and it is important to know what those options are. Some of them will include surgery, seed brachytherapy (radioactive implants), external radiation therapy, or a combination of options.

If the cancer has spread, hormone therapy may be offered, or removal of the testicles to stop testosterone from being produced (to stop it from making the cancer grow and spread faster.) Chemotherapy may also be named as a treatment option for prostate cancers in advanced stages.

By all means, get more than one medical opinion on your treatment before making a final decision. A doctor in one specialty may prefer one treatment while another doctor would recommend another treatment. You may even want a second opinion with another doctor in the same specialty as one you have already seen, especially if all of your questions have not been addressed and answered to your satisfaction.

Do your homework and make a decision based on what is best for your particular case after knowing and fully understanding the options. You should be the one understanding enough about the disease to make a final decision because your doctors are only your advisors in that decision.

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