Newswise — Patrick Shannon was relishing his recent retirement when his primary care doctor called with unexpected news. A blood test showed elevated prostate-specific antigen (PSA) – a warning signal. “I would have never known I had a prostate problem,” said Shannon. “I had no signs.” “Prostate cancer is silent when it’s curable,” says Dr. Joseph Trapasso, Shannon’s urologic oncology surgeon at Penn State Health St. Joseph Medical Center. He explains what to know about getting checked and treated for prostate cancer.
How common is prostate cancer?
About one in eight men will get prostate cancer, the second-leading cause of cancer death in men, according to the American Cancer Society. Early-stage prostate cancer is less deadly than metastatic disease that has spread to other organs or bones. “The five-year survival rate for prostate cancer, if diagnosed early, is 99%, whereas if it’s metastatic, the five-year survival rate is one-third of that, 33%,” says Trapasso. “That’s a dramatic difference.”
What are the major risk factors for prostate cancer?
- Age. Prostate cancer risk rises rapidly after age 50, the American Cancer Society says. About six in 10 prostate cancers are found in men older than 65.
- Race. Black men have a higher risk of prostate cancer than men from other ethnic backgrounds.
- Family history. If you have relatives who have had prostate or breast cancer, your risk is elevated.
When should men get checked for prostate cancer?
Trapasso recommends screening for men age 50 and older. Start at 40 if you have a father, brother or uncle who had prostate cancer or a mother, sister or aunt who had breast cancer. Prostate and breast cancers share genetic mutations that can cause them. Screening rates have dipped in recent years, so many men are overdue.
What are the symptoms of prostate cancer?
Early prostate cancer often shows no signs. As the cancer grows, symptoms can include:
- Trouble starting to urinate
- Frequent urination, especially at night
- Pain or burning during urination
- Blood in the urine or semen
- Erectile dysfunction
- Unexplained weight loss or fatigue in later stages
Do men over 70 still need to be screened?
Some prostate cancer screening guidelines suggest that men over 70 don’t need screening. But those recommendations are receiving new attention since former President Joe Biden was diagnosed with advanced prostate cancer at age 82.
For Shannon, who was in his late 60s at the time, further testing revealed stage 1 prostate cancer. Because it was caught early, the cancer hadn’t spread and was more treatable. Shannon chose robotic surgery with Trapasso to remove his prostate.
What does prostate cancer screening involve?
It starts with a brief symptom questionnaire. Next is a blood test for PSA, a protein produced by the prostate. “PSA can be elevated for a few reasons that don’t relate to cancer, such as enlargement or infection,” says Trapasso. “In the absence of those two, a high PSA is the first real warning sign of prostate cancer.” PSA can rise before symptoms start or a noticeable tumor forms. A digital rectal exam is also part of the screening. A health care provider briefly inserts a gloved finger into the rectum to feel for lumps or hard areas on the prostate. “About 20% of prostate cancers have a normal PSA level, so feeling a growth could be the first way your doctor knows there’s something wrong,” says Trapasso.
How is prostate cancer treated?
Patients have the most options when cancers are diagnosed at stage 1 or stage 2. Treatments can include:
- High-intensity focused ultrasound (HIFU): Uses sound waves to destroy cancer cells.
- Robotic surgery: A radical prostatectomy removes the prostate.
- Radiation therapy uses radiation to destroy cancer cells. It is also an option for the higher stages of cancer.
- Surveillance can simply monitor non-aggressive prostate cancer for changes.
- Clinical trials can offer access to leading-edge treatments. “People think clinical trials are for only for people with no other options, but that’s not true,” says Marc Rovito, vice president of cancer services at Penn State Health. “People with earlier stages of disease can also benefit from participating in clinical trials.”
For advanced (stage 4) cancers, hormone therapy (androgen deprivation) and chemotherapy are often used, which can have systemic side effects. PARP inhibitor medications can also help kill cancer cells in men with certain genetic mutations. “All prostate cancer patients should be screened for the BRCA gene,” says Rovito. Shannon’s prostate surgery was successful with minimal side effects. More than two years later, follow-up testing indicates he remains cured. He checks in regularly with Trapasso and is thankful he found his cancer and treated it quickly and effectively. “There were times when my doctor would recommend different tests, and I would put them off because I felt fine,” said Shannon. “I never would have known that I had prostate cancer if I hadn’t gotten checked.”
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Learn about prostate cancer clinical trials at Penn State Health: studyfinder.psu.edu
The Medical Minute is a weekly health news feature produced by Penn State Health. Articles feature the expertise of faculty, physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.
