National Prostate Cancer Awareness Month: Prevention is Lifesaving

By: Dr. Stephen Wright, MD, Medical Director of Whittier Street Health Center

September is National Prostate Cancer Awareness Month. Join with Whittier Street Health Center to help prevent and treat prostate cancer. Prostate health is a major men’s health issue, and we want the men in our community to be aware of all the tools that can support their enduring health and wellness.

REMEMBER:

• Each man should get screened for prostate cancer starting at the age of 45-50, and at age 40-45 for those men at increased risk.

GENERAL INFORMATION ABOUT THE PROSTATE

• The prostate gland is located in the male reproductive system just below the bladder and in front of the rectum.
• The prostate gland is approximately the size of a walnut and it surrounds part of the urethra, which is the tube that empties urine from the bladder.
• The prostate gland produces fluid that makes up part of semen.

PROSTATE CANCER

Prostate cancer is the most common non-skin cancer diagnosed in men, and the second leading cause of cancer deaths in men, after lung cancer.

Prostate cancer is a disease in which malignant cancer cells form in the tissues of the prostate. Most prostate cancers begin in cells that make and release mucus and other fluids in the prostate. These are called adenocarcinomas.

Prostate cancer often has no early symptoms, however advanced prostate cancer can cause men to urinate more often or have a weaker flow of urine, blood in semen, discomfort in the pelvic area, or erectile dysfunction.

BENIGN PROSTATIC HYPERPLASIA

As men age, the prostate may get bigger. A bigger prostate may block the flow of urine from the bladder and cause problems with sexual function. This condition is called benign prostatic hyperplasia (BPH), and although it is not cancer, surgery may be needed to correct it. The symptoms of benign prostatic hyperplasia or of other conditions in the prostate may by similar to symptoms of prostate cancer.

WHAT ARE THE NUMBERS?

• It is estimated that more than 288,300 men in the United States will be diagnosed with prostate cancer in 2023. Approximately 14.7% of all new cancer cases (National Cancer Institute).
• It is estimated that 34,700 men are expected to die from prostate cancer in 2023. Approximately 5.7% of all cancer deaths.
• Prostate cancer accounts for 1 in 8 new diagnoses of cancer in men.
• Prostate cancer develops mainly in older men. The median age at the time of diagnosis is approximately 66.
• The incidence of prostate cancer is approximately 73% higher in black men than in white men for reasons that remain unclear.
• Black men in the U.S. and Caribbean have the highest documented prostate cancer incidence rates in the world.
• More than 3.1 million prostate cancer survivors are alive today.
• There are an estimated 6,430 new cases of Prostate Cancer and 680 deaths from Prostate Cancer in Massachusetts in 2023 (American Cancer Society).

RISK FACTORS

• Being 50 years of age or older
• Being black
• Black men are more likely to have a more aggressive or more advanced prostate cancer
• Having a brother, son, or father who has/had prostate cancer
• Eating a diet high in fat or drinking alcoholic beverages
• Obesity
• Lack of exercise

WHAT IS SCREENING?

Cancer screening means looking for cancer before it causes symptoms. The goal of screening for prostate cancer is to find cancers that may be at high risk for spreading if not treated, and to find them early before they spread.

There is no standard test to screen for prostate cancer. Two tests that are commonly used to screen for prostate cancer are Prostate Specific Antigen (PSA)

Test and Digital Rectal Examination (DRE) (Centers for Disease Control and Prevention).

Prostate cancer screening may begin for men age 45 to 50, and age 40-45 for those at increased risk based on the following factors: Black ancestry, germline mutations (BRCA1/2), strong family history of prostate cancer.

PSA SCREENING

A blood test called prostate specific antigen (PSA) test measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer. The PSA level may also be elevated in other conditions that affect the prostate.

As a rule, the higher the PSA level in the blood, the more likely a prostate problem is present. But many factors, such as age and race, can affect PSA levels. Some prostate glands make more PSA than others. PSA levels can also be affected by certain medical procedures, certain medications, an enlarged prostate, a prostate infection.

Because many factors can affect PSA levels, your health care provider is the best person to interpret your PSA test results. If the PSA test is abnormal, your health care provider may recommend further evaluation and testing including a biopsy to find out if you have prostate cancer.

DIGITAL RECTAL EXAMINATION (DRE)

Digital rectal examination is when a health care provider inserts a gloved, lubricated finger into a man’s rectum to feel the prostate for anything abnormal, such as cancer (Centers for Disease Control and Prevention).

RISKS OF PROSTATE CANCER SCREENING

• Finding prostate cancer may not improve health or help a man live longer.
• Follow-up tests, such as a biopsy, may be done to diagnose cancer.
• False-negative test results can occur, and false-positive tests can occur.

REMEMBER

1. The most important thing a man can do is to attend regular yearly physicals with his primary care health provider.
2. Know your family history of prostate cancer.
3. Each man should get screened for prostate cancer beginning at 45-50, and age 40-45 for those at increased risk such as having Black ancestry, germline mutations (BRCA1/2), strong family history of prostate cancer.
4. Discuss with your health care provider when you should begin prostate cancer screening.
5. Engage in shared decision making about the prostate screening process with your health care provider to determine what is most appropriate for you, based on your values and preferences.
6. Since there is a lot of information on the internet about prostate cancer and prostate cancer screening, please make sure you visit reputable websites with the most accurate and scientifically based information such as: American Cancer Society: cancer.org

Centers for Disease Control and Prevention: www.cdc.gov

Massachusetts Prostate Cancer Coalition: www.masspcc.org

National Cancer Institute: www.cancer.gov

National Comprehensive Cancer Network: www.nccn.org

At Whittier Street Health Center, we are here to help you with your health care needs. Make an appointment, and come into the clinic as soon as possible. Let us help you improve your health and stay healthy.

For more information or to schedule an appointment, please call 617-989-3039.