Of the many health issues that men face throughout their lives, prostate cancer ranks as one of the most prevalent. In fact, among males, prostate cancer is the most common type of cancer aside from skin cancer. Despite its frequent occurrence, the disease is often overlooked and misunderstood.
“1 in 8 men will get prostate cancer,” says Craig Rogers, M.D., a urologist with Henry Ford Health. “More than 175,000 men are diagnosed with prostate cancer each year and there are more than 30,000 deaths from it each year. Of these deaths, many are diagnosed in an advanced, untreatable stage.”
If it’s caught in time, however, prostate cancer is very treatable. Here, Dr. Rogers answers all of the questions men should know about prostate cancer.
Q: What’s happening to your body when you have prostate cancer?
A: When you have prostate cancer, an abnormal growth of cells has originated in the prostate gland, which is a male accessory sex organ. If the cancer is in a late stage, this growth of abnormal cells can spread to the bone or lymph nodes.
Q: What are the symptoms of prostate cancer?
A: Prostate cancer is usually slow growing and has no symptoms unless it’s relatively advanced. In advanced stages, men may notice urinary symptoms like obstruction of the flow of urine, or blood in their urine or semen. In late stages, bone pain is common. But most men won’t know they have it unless they get tested.
Q: What are the risk factors for prostate cancer? Who should get tested and when?
A: Advanced age is a risk factor—the longer someone lives, the more likely he is to get prostate cancer. Genetics also play a role. If you have a family history of prostate cancer, a female in your family who has had ovarian or breast cancer, or a family member who carries the BRCA mutation (a breast cancer gene), you are at a higher risk of getting prostate cancer. Black men are more likely to develop prostate cancer and die of prostate cancer.
If you are in one of these high-risk categories, you should start getting screened for prostate cancer in your 40s. If you are at a normal risk level, you can begin screenings at age 50. Some people get them yearly, some get them every other year. Many men don’t want to think about this—they avoid it—but for their loved ones and their families, they should get tested.
Q: What does the screening consist of?
A: Screening typically consists of a prostate-specific antigen blood test (PSA) and a digital rectal examination (DRE). If either test is abnormal, further testing is done with a prostate biopsy, which involves obtaining a small sample of prostate tissue.
The PSA and DRE are how people have been screened for decades, but a more recent option is the use of prostate MRI, which has been shown to improve the detection of cancers that are likely to be aggressive and cause harm.
Q: How is prostate cancer treated?
A: It’s usually treated with surgery to remove the entire prostate, or radiation to treat the entire prostate. Surgery to remove the prostate is done with a minimally invasive robotic approach, which was pioneered at Henry Ford. There’s also a middle-of-the-road approach called ablation where you can freeze prostate tissue or use microwave energy to destroy it. One advantage to this is that it can be done in a targeted way. If someone has prostate cancer on one side of the prostate, instead of treating the entire prostate, we can do an area-specific treatment. More advanced cancers might involve a combination of surgery, radiation and hormonal therapy.
For people who have very slow-growing cancers, active surveillance is an option. In these cases, we refrain from treatment so the patient can avoid potential side effects of treatment. Instead, we actively monitor the cancer and gauge its growth with repeated PSA testing, imaging, and occasional biopsies. If the cancer starts growing, we’ll start treatment. But if the cancer stays the same (which it could for a year, or five, or more), then we can delay or avoid treatment.
Q: What are the side effects of prostate cancer treatment?
A: The main side effects we worry about are urinary incontinence and erectile dysfunction. That’s why we're hesitant to treat slow-growing cancers.
Q: What are the survival rates of prostate cancer?
A: Prostate cancer is very survivable if treated. The 5-year survival rate is upward of 98% if caught at a treatable stage. More advanced prostate cancers can also be survivable, although they might involve more rigorous treatment. But there’s solid evidence that treatment of prostate cancer can save lives.
Q: Is there anything you can do to reduce your risk of prostate cancer?
A: Men who eat a healthy diet and exercise may be less likely to get prostate cancer. Avoid red meat (especially charred red meat) in high quantities. Watch your weight, don’t smoke, and live a healthy lifestyle—this can help reduce your risk.
Learn more about prostate cancer screening and treatment at Henry Ford. To make an appointment with your primary care doctor or a urologist, call 1-800-HENRYFORD (436-7936) or visit henryford.com.
Craig Rogers, M.D., is a urologic oncologist and the chair of urology at Henry Ford Health. He specializes in robotic surgery for prostate cancer, kidney cancer, adrenal tumors, testis cancer, penile cancer and bladder cancer. Dr. Rogers sees patients at Henry Ford Hospital in Detroit and Henry Ford West Bloomfield Hospital.
