What Men Need to Know About Prostate Cancer

By Terence Chapman, MD, Director of Urologic Oncology, Lexington Medical Center Urologist, Lexington Urology.

Prostate cancer is one of the most common types of cancer in men. While it is a diagnosis that men dread receiving, the survival rate for men with prostate cancer has increased over the years thanks to better screening and treatment options. While 1 in 6 men will be diagnosed with prostate cancer, only around 1 in 33 die of the disease.

Risk Factors

There are multiple risk factors for prostate cancer; some are genetic, but some can be reduced by diet and lifestyle choices.

Age — While 1 in 6 will be diagnosed with prostate cancer, the risk of getting prostate cancer increases as men age.

Ethnicity — African-American men have a higher incidence of the disease, and they are more likely to get it at an earlier age, have more aggressive cancers and a higher risk of death than other men.

Family History — Men who have an immediate family member (father, brother) diagnosed with prostate cancer are more likely to develop the disease.

Smoking — There is evidence that prostate cancer risk may be double for heavy smokers. Smoking is also linked to a higher risk of dying from prostate cancer.

Diet/Lifestyle — The risk may be higher if you eat more calories, animal fats, refined sugar and not enough fruits and vegetables. Lack of exercise is also linked to poor outcomes.

Obesity — Being obese increases the risk of dying from prostate cancer. A man can decrease risk by maintaining a healthy weight

Screening

It is recommended for all men to have a baseline PSA at age 40 which can help determine future relative risk and to individualize screening frequency based on a number of factors including their overall health, initial PSA level, prostate size, race and family cancer history.

It’s also important to know that an elevated PSA doesn’t always indicate cancer. Many men may have slightly elevated PSA levels because of other causes

After age 70, the value of PSA screening likely declines, depending on a man’s overall health.

Diagnosis

If there is a significantly high or increased PSA level or a significant change in prostate size, a prostate biopsy may be indicated. Through biopsy and additional testing, the physician diagnose prostate cancer and more accurately determine the severity (grade and stage) of the cancer.

Dr. Terence Chapman

Treatment

Though there are multiple treatment options, many cancers will not require treatment. In fact, more men than ever are eligible for initial surveillance. Faster growing tumors that are potentially life-threatening are more likely to require treatment.

Patients and physicians collaborate to determine the right course of treatment, depending on the tumor’s grade and stage, age and overall health of the patient as well as the patient’s willingness to accept potential side effects of treatment.

Treatment choices for prostate cancer include:

• Surveillance, including active surveillance and watchful waiting to monitor the tumor’s growth
• Localized therapies, including surgery, radiation therapy, cryotherapy and focal therapy
• Systemic therapies, including hormonal therapy, chemotherapy and immunotherapy

At Lexington Medical Center Cancer Center, an affiliate of Duke Health, we follow the National Comprehensive Cancer Network guidelines for treating prostate cancer. Our multi-disciplinary team of surgeons, medical oncologists, radiation oncologists, pathologists, nurse navigators and social workers meets bi-weekly to collaborate and determine the best course of treatment for each patient diagnosed with prostate cancer. We also participate in clinical trials to offer new treatment options to our patients.