Detecting Prostate Cancer: Be in the Know

stethoscope

By Nancy Muller, PhD, MBA

Executive Director of the National Association For Continence

 
Less than a year ago, May 21, 2012 to be exact, the U. S. Preventive Services Task Force (USPSTF) issued a resounding recommendation against the PSA blood test for asymptomatic men, regardless of age, in seeking early detection of prostate cancer. The federal task force of healthcare professionals reasoned that the screening test put men possibly at greater risk of harm stemming from false positives (leading one to have unnecessary surgery or other treatment), unnecessary subsequent diagnostic procedures (such as biopsies) than relying on the digital rectal exam by a physician (which as many as half of all male patients refuse from their primary care doctors) and/or waiting until presumably symptoms surfaced. Infection is the most likely adverse event occurring after a prostate biopsy. If diagnosed with cancer, undesirable, adverse outcomes from surgical treatment and even radiation seed implant can be impotence and incontinence. An estimated 10-15% of all men undergoing a radical prostatectomy, for example, will find themselves struggling to managing incontinence a year after surgery. Most men are totally ill-prepared to address incontinence, much less advised to undertake pelvic floor muscle strengthening prior to surgery. Options for addressing the erectile dysfunction that may occur are more numerous and better known, including medications, vacuum pumps, and penile implants.

Prostate cancer is known to be one of the slower growing forms of cancer, especially in older men. Early stages of the cancer may not reveal any readily apparent symptoms. The Mayo Clinic staff 1advises that symptoms in the case of more advanced prostate cancer may often include one or more of the following:

  • Trouble urinating
  • Decreased force in the stream of urine
  • Blood in the urine
  • Blood in the semen
  • Swelling in the legs
  • Discomfort in the pelvic area
  • Bone pain

Already, men are not as proactive as women in preventive health care in general. They are not likely to have annual “well man” checkups like women have as “well women” exams for cervical and breast cancer. Men are more likely to go to the doctor when something is wrong and symptoms are interfering with their daily lives or work.  Without a PSA screening test when visiting the doctor, men are at an even greater disadvantage of having prostate cancer detected.  It stands to reason that we should show some alarm, as the American Cancer Society reports that excluding skin cancers – whose diagnosed incidence has exploded in the last 20 years as sun worshipping baby boomers are paying the price of using baby oil instead of wearing sunblock and hats – prostate cancer is the most frequent form of cancer in the U.S., even ahead of breast cancer.   The American Urological Association has loudly voiced its opposition to the USPSTF’s recommendation by sharing the fact that prostate cancer mortality has declined 40% since annual prostate cancer screening with PSA tests for men age 50 and older became the norm in medical practices and widely promoted two decades ago.  Even more encouraging is the health statistic that the five-year survival rate for men diagnosed with early stage prostate cancer and who underwent proper treatment exceeds 90%.

Although National Prostate Cancer Awareness Month is September each year, every month of the year we need to remind ourselves that staying healthy is our responsibility.  Be aware of your risk factors and speak to your doctor about any concerns:  advancing age, obesity, African-American heritage, and family history of prostate cancer.  Open your eyes in advance of a biopsy to the risk factors of procedures and treatment.  Lose that excess weight and keep it off. Get informed so you aren’t panicking after the fact, discovering your chronic incontinence.  Make it your job to live not only longer but a healthier, high quality life. There are solutions and NAFC is there to help you.

 

1 Accessed at http://www.mayoclinic.com/health/prostatecancer/DS00043/DSECTION=symptoms, available February 12, 2013.

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