Could You Be at Risk for Prostate Cancer?

The prostate is a small, walnut-sized gland located below the bladder and in front of the rectum. The urethra, the tube that carries urine and semen out of the body through the penis, runs through the center of the prostate. As men age, the prostate gland increases in size, causing the urethra to narrow and decrease urine flow. This is a common prostate change not related to cancer. But when the cells within the prostate begin to grow out of control, that’s when cancer can develop.

According to the Centers for Disease Control & Prevention, 13 in 100 American men will get prostate cancer during their lifetimes—and about 2 to 3 men will die from prostate cancer. September is Prostate Cancer Awareness Month. Now’s the time to spread the word about risks that may affect you or your loved ones, and join Frederick Regional Health System in the fight to #endcancer.

Who Is at Risk for Prostate Cancer?

Every man is at risk for prostate cancer. The most common risk factor, however, is age. As a man ages, his chance of getting prostate cancer increases. Some men are at increased risk for prostate cancer, depending on their ethnicity and family history. The following people are at higher risk for developing prostate cancer and should be screened:

• African-American men…
  • Are more likely to get prostate cancer than other men—and more than twice as likely to die from prostate cancer than white men.
  • Get prostate cancer at a younger age, tend to have more advanced disease when it’s found, and tend to have a more severe type of prostate cancer than other men.
• Men who have a father, son, or brother with prostate cancer.
• Men with three or more first-degree relatives (fathers, sons, brothers), or two close relatives on the same side of the family with prostate cancer.

Men who are not African-American and do not have a family history of prostate cancer are at average risk.

What are the Symptoms of Prostate Cancer?

Often, there are no warning signs of prostate cancer because the growing tumor does not push against anything to cause pain. For many years, prostate cancer may be silent, which is why screening is so important for all men and their families. Like many conditions, early detection can lead to more successful treatment.

In rare cases, however, prostate cancer can cause symptoms such as:

• Blood in the urine or semen
• Difficulty in having an erection
• Needing to urinate frequently, especially at night
• Pain or stiffness in the lower back, hips, pelvis, or thighs
• Painful ejaculation
• Painful or burning urination
• Trouble starting or holding back urination
• Weak, dribbling, or interrupted flow of urine

Men can experience urinary symptoms as the prostate enlarges with age, but it’s important to remember that urinary symptoms do not necessarily mean you have cancer. Diseases such as prostatitis or benign prostatic hyperplasia are benign diseases that cause similar symptoms. Regardless of what’s causing the symptoms, if you’re experiencing any of these scenarios, talk your doctor.

What Is Prostate Cancer Screening?

A screening is a preventative measure to look for a disease or condition before it causes symptoms in the body. There are two types of prostate cancer screenings: the DRE (digital rectal exam), where the physician feels for enlargement or irregular shaping of the prostate, and the PSA (prostate specific antigen), which is a blood test that measures the level of prostate-specific antigen in the blood. Both screenings are routine and relatively painless.

Screening for prostate cancer can begin as early as 40 years of age if you have a family history, but for those at normal risk, screening can begin at age 50. The age to start screening depends on your individual factors, but here are some common screening guidelines based on age:

• Age 40 - If you have a family history
• Age 45 - If you are African-American
• Age 50 - If you have no family history
• Age 55-69 - Discuss with your doctor if PSA screening is appropriate
• Age 70 or older - PSA screening is not recommended

How Is Prostate Cancer Diagnosed?

If your screening reveals abnormalities, a doctor will perform a biopsy—a procedure that removes a small piece of tissue from the prostate. The tissue will be checked for cancer cells underneath a microscope. Biopsies are the primary tool for diagnosing prostate cancer, but your doctor may opt for other tools, like a transrectal ultrasound, to take pictures of the prostate instead.

If prostate cancer is found, other tests may be done to find out if the cancer cells have spread within the prostate and throughout the body. This process is called staging. The progression of cancer (whether it’s only in the prostate or has spread to other parts of the body) determines the stage of prostate cancer and the treatment options your doctor will recommend.

How Is Prostate Cancer Treated?

There are several treatment options for prostate cancer. Some patients may be treated with radiation therapy, where machines use high-energy rays (similar to X-rays) to kill the cancer. Some patients need surgery, called a prostatectomy, to remove the prostate as well as surrounding tissue affected.

Other patients turn to various therapies including chemotherapy using special drugs to shrink or kill the cancer; cryotherapy to freeze and kill cancer cells; biological therapy using the body’s immune system to fight the cancer; high-intensity focused ultrasound sending sound waves to kill cancer cells; or hormone therapy to block cancer cells from getting the hormones they need to grow.

If you’re eligible, your doctor may also recommend clinical trials that bring life-extending and new curative treatments for cancer patients. Complementary or integrative therapies may also be combined with traditional treatment options to create a plan of care for patients that addresses the total body, mind, and spirit. Unique options like mindfulness and yoga help to reduce stress, improve treatment-related side effects, increase feelings of mental and physical well-being, and support the healing process. Integrative therapies are available locally at the James M Stockman Cancer Institute.

“Mounting evidence supports that cancer patients and their families benefit from these therapies,” says Dr. Patrick Mansky, the Medical Director for Medical Oncology and Integrative Care at Monocacy Health Partners Oncology Care Consultants and an MD Anderson Certified Physician. “It’s becoming the state of the art when you look at all the large cancer centers in the country and aligns with our program goal of creating an optimal healing environment. It’s the preferred and optimal approach to care, and most of our patients who have gone through these approaches have been very pleased.”

Complementary therapies currently offered through FRHS include:

• Exercise - Yoga and tai chi practiced under the supervision of an experienced teacher may help patients overcome fatigue associated with cancer treatment. “We know that movement, especially a mind-body approach, reduces stress and fall risks for cancer patients and can help with cancer related fatigue,” says Dr. Mansky. “There’s increasing evidence that these therapies help caregivers with their stress, too.”
• Diet - “There’s a strong interest in nutrition and understanding what’s best to eat and what supplements to use,” says Dr. Mansky. Diets rich in whole grains, fresh fruits and vegetables, especially green, leafy ones, can increase energy and help promote digestion.
• Acupuncture - Studies have shown that acupuncture can help with nausea and vomiting, fatigue, hot flashes, neuropathy, anxiety, depression, and sleep issues.
• Massage - Cancer patients sometimes experience edema or swelling that occurs when fluids build up in parts of the body, especially the legs, ankles, and feet. Massage by a licensed therapist can help relieve swelling. Reiki, or spiritual healing by touch, may encourage emotional support and help with symptom control, too.
• Mindfulness - According to Dr. Mansky, evidence shows that patients who practice mindfulness through meditation experience less stress when going through cancer therapy and recovering from treatment.

Targeted Treatment with CyberKnife

Another treatment option available to men with prostate cancer is CyberKnife. This targeted treatment delivers beams of high-dose radiation with extreme accuracy, targeting only the affected areas of the body. In many cases, results are equal to—or better than—traditional surgery. These treatments, in many cases, are also more effective than conventional radiation. Patients can also complete CyberKnife treatment in just one to five days, compared to the weeks it takes for conventional radiation therapy. There’s no surgery, few if any symptoms, no pain, and no recovery time. Plus, it’s non-invasive, and no anesthesia is required.

Dr. Greg Gagnon, medical director of Radiation Oncology at FRHS and an expert in treating prostate cancer, led the way to bring CyberKnife to the Frederick community. “It’s a robotic unit that travels around the body to target tumors anywhere in the body,” Dr. Gagnon says. “It’s wonderful because, if you can accurately delineate where a tumor is, you can treat it with this technology and blast it with very large doses of radiation while avoiding normal tissue very near it. A tumor is unlikely to survive the doses we can deliver to it with this technology.”

When David Girton was diagnosed with prostate cancer a few years ago, he turned to Dr. Gagnon and the oncology team at FRHS. After learning about his treatment options from Dr. Gagnon, David opted for CyberKnife. He wanted to continue working during his treatment, and he knew other options would not only be more expensive but also require more treatments over a longer period of time. “CyberKnife was only five treatments over the course of a week,” he says. “So, that’s what I elected to do; then I could turn around and go to work the same day.”

David was told he’d feel a little tired after treatment (one of very few symptoms of CyberKnife), but he says it wasn’t enough to interfere with his day. He could get the treatment he wanted close to home. “Had they not had CyberKnife,” he says, “I don’t know what I would’ve done.”

Together, We’ll End Prostate Cancer

Understanding your diagnosis and treatment options is the first step in fighting prostate cancer. At FRHS, we’re committed to providing you with a cancer treatment experience that is focused on you. Learn more about prostate cancer screenings, treatment, and the care team at FRHS.