Dr. John Lynch, chairman of urology at Georgetown University School of Medicine and also a chair of the Prostate Cancer Education Council visits The Early Show with these statistics:
- An estimated one in six American men will get prostate cancer.
- Almost 200,000 new cases will develop every year.
- About 40,000 men die each year, which makes it the second leading cause of cancer death in this country.
- It ranks on the same level as breast cancer for women.
Detection and treatment:
There's a number of ways to detect prostate cancer, although the digital rectal exam and a blood test called the PSA are the most common. The PSA test - or prostate specific antigen test - is quick and easy.
But The PSA test is not without it's controversy. Some doctors have claimed that since many men will develop prostate cancer eventually, older men will often die from other causes before a slow-growing prostate tumor kills them. Surgical treatments are not without risks of incontinence and impotence for those men. The bottom line is that for those who get the disease at a younger age, screening can help catch this killer early.
The current guidelines say routine exam at age fifty or at age forty for those with a family history of disease or for African-Americans, but those guidelines are widely thought to be outdated, says Dr. Lynch. More and more doctors are now recommending testing at age 45 and 35 respectively.
"Men need to see their doctors for a digital rectal exam and the PSA test as well. If you have a family history of prostate or any other kind of cancer, that puts you at higher risk and you need to talk to your doctor about being more vigilant and perhaps being tested even earlier," he says.
Besides the PSA, there is now the complexed PSA, a newer version of the prostate cancer test.
"If the standard PSA in the past showed a mildly elevated level, usually a biopsy would be needed to check what might be a benign condition. Now doctors can give the complexed PSA blood test - a little more exact - and avoid unnecessary biopsy," says Dr. Lynch.
Studies show the new complexed PSA tests may result in fewer false positive diagnoses of prostate cancer than the current PSA, he adds. "If those findings hold up, it means a reduction in the number of biopsies necessary to detect the disease by about 44,000 biopsies each year in the U.S."
The Prostate Cancer Education Council this month will start further testing of the new complexed PSA test by offering free or low-cost screenings around the country. They made the decision based on recent studies of the complexed PSA test results presented at recent medical conferences.
"Given the growing weight of scientific evidence, the Council decided to offer the new test for further evaluation. From Sept. 15-22, more than 500 hospitals, clinics and private physicians will provide free or low-cost screenings to more than 100,000 men nationwide," says Dr. Lynch.
Men or their families can schedule a screening by calling 1-866-4Prost8 or by visiting PCAW.com to find a screening location in their area.
Dr. Lynch, 55, is a prostate cancer survivor. He was diagnosed after a mildly elevated PSA test. Eight weeks ago, he had surgery to remove the cancer. The margins of the remaining tissue were clear following surgery, meaning the surgeons were successful in getting rid of all the cancer without the need for other treatments. He is a living example of why it's important to be screened for prostate cancer. He has a family history of prostate cancer, which makes early screening even more important.
Prostate cancer has an excellent cure rate for cases detected early, he says. "Once a patient is diagnosed, the next step is for doctors to find out exactly where in the prostate the cancer is, and how far it's spread. New imaging techniques can help, including the injection of a radioactive liquid that binds specifically to prostate cancer cells and highlights their exact location. A computer generates a 3-D image, which allows doctors to target the cancer more accurately, even if it has spread beyond the pelvic area. But we still need better imaging to detect cancer in its early stages," Dr. Lynch says.
There are different kinds of treatment available for prostate cancer, Dr. Lynch explains:
Surgery - It remains an effective way to get rid of prostate cancer, and surgical techniques are constantly being refined to make sure that no damage occurs to surrounding nerves and body structures, resulting in incontinence or impotence.
Radiation therapy - Another common treatment is either an external beam, which is directed at the cancer from outside the body, or little seeds, which are implanted in the prostate to burn the cancer away from within.
Surgery and radiation are the first-line defenses against prostate cancer, but in some cases the cancer comes back, and for many of those people, further surgery or radiation is not an option. For those men, hormone therapy or chemotherapy can slow down the spread of the cancer.
Cryosurgery – A treatment that's gaining a lot more attention these days as a second line of defense is cryosurgery, a procedure that's been around for a while. Instead of burning the tumor cells away with radiation, the surgeon injects super-cool gas that forms a bubble around the tumor to freeze the cancer cells to death. Doctors monitor the progress using ultrasound. It's making a comeback because of new minimally invasive techniques - incisions are much tinier than they were in the past and better imaging techniques that make it possible to deliver the freeze much more accurately. Medicare will pay for it in cases of a localized cancer that hasn't spread or as a second-line treatment when the others fail.
Patients who are much older and have a localized, slow-growing cancer don't always get immediate radical treatment, because the cancer may not as big a risk for them as other health issues, and surgery can be very debilitating for older folks. Another potential treatment being looked at for the future is high-intensity ultrasound, which generates heat to kill cancerous cells.
It's estimated 50 percent of men who should be tested for prostate cancer have not been tested. Boys and men are not socialized to take care of their bodies the same way women are, especially with an area as sensitive as the prostate. Many studies have shown that men are reluctant to talk about their problems and seek medical care. That's why it's important for public figures like General Schwarzkopf or Sidney Poitier to come out and talk about these problems. It sends a message to other men that it's OK to talk about these problems. When it comes to making prostate exam appointments, wives usually make most of the appointments for their husbands.