What every man should know about prostate cancer

Having a healthy prostate is important because it affects both sexual and urinary functions. But many men tend to put off regular health checkups and screenings — particularly when it comes to the prostate.

The prostate gland is about the size of a walnut and sits just below the bladder and in front of the rectum. Its primary function is to produce the liquid that transports sperm.

According to Dr. David Bodkin, a board-certified oncologist affiliated with Sharp Grossmont Hospital, prostate cancer is the second-leading cause of cancer-related death in men after lung cancer. One in 8 men will develop it in their lifetime.

“As with most cancers, when prostate cancer is caught early, it’s easier to treat and the chances for survival are good,” he says.

When should men be screened?

Dr. Bodkin recommends men at average risk consider beginning screening for prostate cancer at age 50. A discussion of personal and family health history will take place, followed by a prostate specific antigen (PSA) test and possibly a physical prostate exam.

Men should then continue to be screened every one to two years, depending on their PSA level, a gauge for a certain protein that, when high, can be a sign of cancer.

For men who are at higher risk, including those with a family history of prostate cancer and African American males, initial screening is recommended at age 45.

Screening can help detect symptoms before they start, and Dr. Bodkin says it’s important for men to talk with their doctor about the pros and cons of screening and what’s right for them. A growing number of experts feel that prostate cancer is slow-growing, and many men who have it may never develop cancer or even know they have the disease until they’re screened.

Top questions about prostate cancer, answered

Here, Dr. Bodkin answers additional questions about prostate cancer:

1. What are the symptoms of prostate cancer?
   Symptoms include weak urine flow, decreased sexual function, painful urination, frequent nighttime urination and presence of blood in the urine or semen. However, in some instances, there are no symptoms at all, which is why screening is important.

2. What are the risk factors?
   The most common risk factor is age. The older a man is, the greater the chance of getting prostate cancer. And according to the American Cancer Society, prostate cancer develops more often in African American men and in Caribbean men of African ancestry than in men of other races. Further, men who have a family history of prostate cancer are at higher risk.

3. What is a PSA blood test?
   A prostate-specific antigen (PSA) blood test measures the level of a protein called prostate-specific antigen, which is made by cells in the prostate. The chance of having prostate cancer goes up as the PSA level goes up, but there is no set cutoff point that can indicate with certainty whether a man does or doesn’t have prostate cancer. If your PSA level is high, you might need further tests.

4. How is prostate cancer treated?
   When a biopsy is done and reveals cancer, a pathologist provides information, such as aggressiveness, extent of invasion, grade and other details that factor into treatment options. A few common options include active surveillance, surgery and radiation therapy. For higher stage disease, treatment may also involve targeted and systemic therapies, including hormonal therapy or chemotherapy, as well as immunotherapy.

5. What is active surveillance?
   Because prostate cancer often grows very slowly, some men — particularly those who are older or have other serious health problems — don’t receive treatment and opt for active surveillance, which usually includes regular monitoring, follow-up doctor visits and testing at regular intervals.

6. Are there any lifestyle changes, such as diet or exercise, that could help reduce risk?
   Eating a balanced diet that includes plenty of fruits and vegetables; avoiding or limiting red and processed meats as well as fatty foods; and keeping physically active to maintain a healthy weight can help decrease risk.

7. Are there any new advancements in the detection of prostate cancer?
   Analysis of pathology has changed and become more sophisticated. It's now more than a pathologist looking at a biopsy. The specimen can be sent for analysis of genes — both inherited and acquired mutations in DNA — that are valuable when determining how aggressive the cancer may behave.

Learn more about prostate cancer care at Sharp; get the latest health and wellness news, trends and patient stories from Sharp Health News; and subscribe to our weekly newsletter by clicking the "Sign up" link below.

For the news media: To talk with Dr. David Bodkin, board-certified oncologist, about prostate cancer for an upcoming story, contact Erica Carlson, senior public relations specialist, at erica.carlson@sharp.com.