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Health

Early diagnosis and treatment vital to curing disease that primarily targets older men


Published:   |   Updated: July 6, 2013 at 02:27 PM

Three years ago, Frank Lockwitch was diagnosed with prostate cancer. In his late 60s, the Bushnell resident had been receiving annual screenings as part of his routine yearly exams.

"I had an enlarged prostate," Lockwitch said. He had no unusual symptoms, other than his age, which accounts for most enlarged prostates. Yet his physician recommended routine screenings to monitor his PSA (prostate specific antigen) levels.

"My levels jumped from around 3 to 5," he remembered, which led to a biopsy and the diagnosis of prostate cancer.

"I opted for radiation," Lockwitch explained, which entailed eight weeks of treatments to remove the cancerous cells. A year and a half later, Lockewitch is now cancer free.

According to the American Cancer Society, prostate cancer is the most common form of cancer in American men, second only to skin cancer. It is the second-leading cause of death, just behind lung cancer, and affects one in six and kills one in 36 every year.

As in most cancers, early diagnosis and treatment are vital to curing the disease. Routine screenings are recommended between the ages of 40 and 75, depending on the individual's risk factors.

The prostate is a walnut-sized gland found only in men. It is located just below the bladder and in front of the rectum. The urethra, or tube that carries urine from the bladder to the penis, runs through the center of the prostate. The gland also contains cells that make semen to protect and nourish the sperm.

The prostate begins development before birth and continues to grow until adulthood. Then, it will either remain near the same size or grow only slightly with age. Male hormones are responsible for the growth. And as long as there are male hormones present, the prostate may continue to grow slightly.

But as the male ages, the inner part of the prostate around the urethra may keep growing, causing benign prostatic hyperplasia, (BPH). BPH can lead to problems while passing urine because the prostate can then press on the urethra.

BPH is not cancer nor does it develop into cancer. But it can become a medical issue in some men, treated with medicines to shrink the size or relax the muscle to allow urine to flow. If medication does not work, a transurethral resection of the prostate, a surgical procedure, might be necessary.

Nearly all prostate cancers, known as adenocarcinomas, begin in the gland cells and usually grow slowly. In fact, autopsy studies show that many older men who died of other diseases also had prostate cancer and didn't even know they had it.

Lockwitch had no symptoms, other than an enlarged prostate, before he was diagnosed. Regular tests of his PSA levels actually helped detect the changes in the size and shape of his prostate, triggering his biopsy.

So who is at risk for prostate cancer and are there precautions aging men can take to help reduce the odds of getting prostate cancer?

A small percentage (5 to 10 percent) of prostate cancers have been linked to inherited DNA changes. Lockwitch was diagnosed one year after his oldest son also received the diagnosis.

The following are some risk factors for prostate cancer:

Age: Prostate cancer is very rare in men younger than age 40. The percentages go up after the age of 50 and nearly 2 out of 3 have been found in men over the age of 65.

Race: It is more common in African-American men who also are more likely to have advanced cases and are more likely to die from the disease.

Nationality: Prostate cancer is more likely found in North America and northwestern Europe and is less common in Asia, Africa, Central and South America.

Family history: Men with close family members (brother or father) who have the disease are likely to also get it, especially if the other family member was young when they contracted the disease. (The risk is higher when it's a brother with the disease over a father.)

Genes

Diet: Red meat and high fat dairy products may be linked, although studies are still out.

Obesity

Smoking: Studies have found a link between smoking and prostate cancer. It also may lead to more advanced prostate cancer and a possible increase in death from the disease.

Infection and inflammation of the prostate: prostatitis (inflammation of the prostate gland) may be linked to an increase in prostate cancer risks.

Prostate cancer is typically suspected in patients whose PSA levels test high during routine screenings or doctor visits. The PSA (prostate specific antigen) is the protein produced by the prostate gland. The higher the PSA level, the more likely the patient has prostate cancer.

The PSA test is widely used to screen men for prostate cancer or to monitor those who have been diagnosed to see if the cancer has recurred after treatment.

Once diagnosed through a biopsy, the patient and his physician will then determine the best course of treatment depending on certain factors of each unique situation. Treatment options include:

Expectant management

Surgery

Radiation therapy

Cryosurgery (cryotherapy)

Hormone therapy

Vaccine treatment

Certain factors are considered before a specific treatment, or combination of treatments, is determined for each specific case. They may include the age of the patient and life span, other serious health conditions, the stage and grade of the cancer, the patient's concerns about each treatment option and potential side effects.

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