The recent diagnosis of prostate cancer in notable figures like Ryne Sanberg, a Chicago Cubs Hall of Fame player, and the passing of Dexter Scott King, Martin Luther King Jr.’s youngest son, due to the same disease, has elevated public awareness. Despite this, many men tend to keep silent about their prostate health issues. Ignoring this prevalent health problem will not lead to its resolution.
Prostate cancer ranks as the top cancer affecting men and is the second leading cause of cancer-related deaths among men in the U.S. Statistics show that one in eight men will be diagnosed in their lifetime. Primarily affecting older men, around 60% of cases are identified in men aged 65 and above, with rare occurrences in men under 40, as per the American Cancer Society. The decision for screening depends on the individual’s age and risk factors.
Promoting Public Health
The American Medical Association (AMA) plays a vital role in public health, with its members working tirelessly in patient care. They focus on improving access to healthcare for underserved communities and devising key preventative measures.
About the AMA Series
The AMA’s “What Doctors Wish Patients Knew™” series offers physicians a platform to share crucial insights about current health issues with patients.This segment features William L. Dahut, MD, the American Cancer Society’s Chief Scientific Officer, discussing key information about prostate cancer.
Risks for Specific Groups
Dr. Dahut, a hematologist-oncologist at Walter Reed National Military Medical Center’s prostate cancer clinic, emphasizes age as a significant risk factor. A family history of prostate cancer in first-degree relatives, like a brother or father, increases the risk. For those with two first-degree relatives with prostate cancer, the risk escalates. He also highlights the BRCA2 gene mutation, commonly associated with breast cancer, which significantly heightens the risk.
African American men have a 70% higher likelihood of being diagnosed and are two to four times more likely to die from prostate cancer compared to other races. Dr. Dahut notes that systemic biases exist in treatment offerings, which contributes to this disparity.
Genetic Mutation Testing
Dr. Dahut advises men with a strong family history of prostate cancer or an aggressive form to get tested for genetic mutations like BRCA2. Identifying such mutations is crucial for both personal risk assessment and family planning. Targeted therapies exist for men with these genetic mutations.
Early Detection and Cure
“Early-stage prostate cancer is incredibly curable,” says Dr. Dahut, with a survival rate exceeding 99% at five years post-diagnosis. However, once it spreads to bones, it becomes incurable, with a life expectancy of three to five years.
The Decline in Screening Rates
Dr. Dahut observes a significant decline in prostate cancer screenings over the past two decades, leading to more cases of advanced-stage diagnoses. He emphasizes the importance of early screening, especially for men at higher risk, including those with a family history, genetic predisposition, or African American men.
The American Urological Association advises using prostate-specific antigen (PSA) tests for early screening, particularly for men aged 40 to 45 with higher risk factors. The US Preventive Services Task Force suggests that men aged 55 to 69 make an individualized decision about screening after discussing the benefits and risks with their physician. For men over 70, PSA-based screenings are generally not recommended.
Screening Benefits and Risks
While screening can reduce prostate cancer mortality in some cases, it also comes with risks such as false positives, overdiagnosis, overtreatment, and treatment complications including incontinence and erectile dysfunction.
Symptoms and Grades of Prostate
Cancer Most men are asymptomatic at diagnosis. Symptoms like increased urinary frequency or obstructive symptoms usually indicate benign prostate growth. However, symptoms like weight loss, bone pain, blood in urine, or fatigue could indicate prostate cancer.
Prostate cancer grading initially uses the Gleason score, which predicts cancer aggressiveness based on cell patterns. Treatments vary based on the cancer stage and whether it’s confined to the prostate, has spread to lymph nodes, or distant organs.
Lifestyle Changes and Treatment Lifestyle changes, such as a heart-healthy diet and exercise, may impact prostate cancer outcomes, particularly in reducing the risk of aggressive forms. Dr. Dahut notes that not all prostate cancers require immediate treatment, and active surveillance is often a viable option.
Impact on Sexual Health Treatments for prostate cancer, especially surgical interventions, can affect sexual function. Dr. Dahut mentions the availability of effective medications for erectile dysfunction. Treatment impacts depend on the patient’s age and health status before the treatment.
Staying Healthy Maintaining physical activity and a low-fat diet is beneficial, especially since some prostate cancer treatments can lead to bone thinning.
Outlook Based on Cancer Aggressiveness The prognosis and treatment plan for prostate cancer depend on its aggressiveness and spread. High Gleason scores necessitate immediate treatment, while less
