September marks the beginning of Prostate Cancer Awareness Month, so I’m putting out a call to action to all men to understand this prominent disease and get screened.
Prostate Cancer is an often-forgotten disease, falling behind the pink ribbons of breast cancer, but what most people don’t know is these are parallel diseases. Take a look at the similarities below.
We have to raise awareness about prostate cancer, which affects more than 233,000 men each year and kills almost 30,000 annually.
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This is no small number but if this disease is caught early, it is 90-95% curable. How do we catch it? We use the PSA blood test as the gateway to information about a man’s risk for this disease.
WHY WE SCREEN FOR PROSTATE CANCER
The PSA is a simple blood sample with a normal range of 0-4 nanograms per milliliter. Urologists will then analyze the velocity of a PSA. Generally speaking, there is no specific normal or abnormal PSA level. The PSA is not a perfect diagnostic test, and as such we rely on other factors such as age, family history, medical history, and background to help us get a clearer picture of what is “normal” for each patient. The amount of PSA present in the blood tends to increase with increasing age.
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So what is normal for a 70-year-old, may not be normal for a man of 40. With that said, 4 ng/mL is often considered the upper limit of normal. Generally, the higher the PSA level, the more likely that cancer is present.
PSA velocity is the rate at which your PSA level increases from year to year. This rate of change in PSA levels over time, can give crucial information to a doctor about your potential for cancer. A rapid increase in PSA or PSA doubling time can be a sign of a rapidly growing cancer. Physicians have suggested that a PSA velocity that is over 0.35 ng/mL per year is the cut off for a high PSA velocity. Therefore an increase of about .65 or .7 in PSA per year can be indicative of prostate cancer, and should be closely monitored and further followed up by a physician.
CHANGING HOW WE DIAGNOSE PROSTATE CANCER
Advances in science and research have led us to believe that there are major underlying reasons for why patients develop cancer and how aggressive it is. Prostate Cancer has been the disease at the forefront of this research around genetic testing and new diagnostic testing to understand the individual patient’s disease fully before jumping to treating it.
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New genetic tests including the 4K Score, PCA3, Oncotype DX and Prolaris have launched in the past year and are working to give us more information about the patient’s risk for the disease. If the patient is diagnosed, these new tools can help direct a better treatment path. These are game changers in terms of the entire process of diagnosing and treating prostate cancer.
PROSTATE CANCER INCREASING AMONG YOUNGER MEN
Known as the silent killer since there are little to no symptoms in the early stages, prostate cancer continues to be very prevalent among younger men.
If it occurs in men age 50 or younger, it’s likely because the tumor is growing rapidly, making for a much more aggressive cancer.
A significant study from researchers at the University of Michigan showed that prostate cancer is more likely to be aggressive, likely due to a rapidly growing tumor.
In the last 20 years, this prominent disease has increased six-fold in younger men. This is why men should get a baseline PSA screening blood test the moment they turn 40.
What does this do? The PSA blood test gives urologists or your primary doctor a starting point. From there, they will measure the velocity of the prostate specific antigen levels over time.
The normal range for a PSA is 0-4. If it exceeds that, it could indicate suspicious activity around the prostate, but not always prostate cancer.
FAMILY HISTORY MATTERS MOST
Even with all the emerging research around how prostate cancer manifests and diagnosing the disease for individual patients, family history is still the highest risk factor. This makes it the most important variable for men to understand and, believe it or not, this type of knowledge is real power.
Peter Latos | Dealing with Prostate Cancer from Dennis Latos on Vimeo.
Prostate cancer is highly treatable, when diagnosed early, but that doesn’t make it any less dangerous or undeserving of less attention.
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Its reputation as a silent killer stems from the limited warning signs. Because of that, men must work closely with their healthcare providers to identify all possible red flags.
It is important for men to know where they stand with prostate cancer. If your father or brother has prostate cancer, particularly if you also meet other risk criteria, make an appointment with a prostate cancer specialist. For high-risk men, that relationship should start long before diagnosis.
Much research over the past few decades has shown that having a first-, second- or third-degree relative with prostate cancer raises a white man’s risks of developing the disease. For white males, a complete family history of prostate cancer among close and distant relatives may gauge personal risk with greater accuracy.
If an extensive family history exists and men are aware, it provides a wider range to estimate individual risks that are potentially more accurate than those based on typical family health histories. Maternal and paternal histories are equally important.
Arming yourself with information about your family history and individual risk factors like obesity, can convert you to being more proactive about your health and prevention.
I would ask you to commit to your future health. Think ahead to your older self, and ask yourself whether avoiding a simple blood test is really worth the risk? My guess is, absolutely not.
Talk to your primary care doctor, or visit a urologist and get screened. The PSA blood test has saved the lives of thousands of men in my care. This is real, and you can take action today.
Dr. Samadi is chairman of urology, chief of robotic surgery at Lenox Hill Hospital and professor of urology at Hofstra North Shore-LIJ School of Medicine. He is a medical correspondent for the Fox News Channel’s Medical A-Team and the chief medical correspondent for am970 in New York City, where he is heard Sundays at 10 a.m.
Learn more at roboticoncology.com and SamadiMD.com. Follow Dr. Samadi on Twitter and Facebook.
