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September is National Prostate Cancer Awareness Month

Prostate Cancer: Speaking Man to Man

Every 3 minutes a man is diagnosed with prostate cancer in the United States. We at Evansville Cancer Center hope that the following information will answer some of your questions about prostate cancer and heigthten the public’s awareness while encouraging men to schedule yearly checkups.

Prostate Brachytherapy Program Internationally Spotlighted!
An ECC presentation outlining the results of HDR Brachytherapy treatment was recently presented in Barcelona, Spain! Click here for more details.

What is the Prostate Gland?
The prostate is about the size of a walnut. It is just below the urinary bladder and surrounds the upper part of the urethra which is the tube that carries urine from the bladder and semen from the sex glands out through the penis. Along with the testes and the seminal vesicles, the prostate is responsible for secreting the fluids that make up semen.
How common is prostate cancer?
Prostate cancer affects 1 in 6 American men. Prostate cancer is second only to lung cancer as the most common cause of cancer death in men. This year, it is estimated that 230,110 men will be diagnosed with prostate cancer and an additional 29,500 men will die from it.
What are the symptoms of prostate cancer?
Many patients with prostate cancer often have no symptoms at all. Those who do have symptoms may experience a weak flow of urine; difficulty urinating; frequent urination; pain or burning during urination; blood in the urine; or pain that does not go away in the lower back, pelvis, or upper thighs. If a man is experiencing these symptoms, he should see a doctor who is qualified to do a prostate exam immediately.

Men should play it safe - After a certain age, every man should go for a yearly prostate exam, whether he suspects he has a problem with his prostate or not. It could be a lifesaver!

At what age should a man start going for yearly prostate exams?
It depends on the individual’s risk of getting prostate cancer. As a rule of thumb, men at higher risk should begin prostate exams by age 40. That includes African Americans and men with a family history of prostate cancer on either side of the family. Men at lower risk (non-African Americans with no known family history of the disease) should begin prostate exams by age 50.
What is a prostate exam?
It is a quick and simple 2-part exam:

- DRE or digital-rectal examination.
During this procedure, the doctor inserts a gloved, lubricated finger into the rectum to feel for any abnormalities on the surface of the prostate. The exam is safe and takes about 5 seconds to perform.

- PSA or prostate-specific antigen blood test.
This is a simple test in which blood is taken from the patient’s arm, and the sample is sent to a laboratory where the PSA level is measured. A high level of PSA in the blood may mean there is possible presence of cancer in the prostate. The result is usually back within 24 hours. The DRE and PSA blood test are very effective when used together. If the tests turn out to be normal, the patient need only to continue with yearly exams. If the DRE and/or PSA blood test are abnormal, additional tests will be needed.

What are the other reasons for a PSA to be elevated?
Reason: Comment:
Enlarged prostate (BPH) Can raise PSA levels 2-3 times higher than normal level.
Common problem - more than half of men over 50 have it.
Infected or inflamed prostate Can raise PSA levels two to three times higher than normal.
Biopsy or operation
on prostate
PSA level may not return to normal for several weeks.
Cancer cells in prostate Although there is no PSA level that tells if you have cancer, the higher the PSA level, the higher your chance of having cancer.

* In general, a PSA of less than 4 indicates that cancer is unlikely. Results above 4, or results showing a rising PSA, regardless of the level, should be discussed with your doctor.

What kind of doctor performs a prostate exam?
Three types of doctors can perform a prostate exam:

- Urologists specialize in problems of the kidneys, bladder, prostate, and testes.

- Primary care physicians qualified to perform a prostate exam include family doctors, internal medicine doctors, general medicine doctors, and geriatricians

- Oncologists specialize in detecting and treating cancer
How is prostate cancer diagnosed?
If either the prostate-specific antigen (PSA) blood test or digital-rectal exam (DRE) are abnormal, the doctor may order a test called a transrectal ultrasound (TRUS)-guided biopsy. The procedure uses sound waves to look for signs of disease in the prostate. First, the ultrasound probe is placed in the rectum, where it can detect the presence of tissue in the prostate that may be cancerous. This is a relatively simple procedure, just like the DRE. Then a tiny needle is used to take a biopsy, or small sample of prostate tissue, from at least 6 different areas in the prostate.

Afterwards, the biopsies are sent to a pathologist, a doctor who specializes in diagnosing cancer or other abnormalities from tissue samples. The results should come back in a few days. If the biopsy is “ negative,” it means there is no cancer. If it is in the “ gray zone,” it means that the prostate is neither normal nor cancerous. In this case, the doctor may order more tests. If the biopsy is “positive,” it means there is cancer. The doctor will then discuss treatment options with the patient.

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