September is Prostate Cancer Awareness Month

by Jewel Johl, MD

In 2012, there are expected to be 241,740 new prostate cancer diagnoses and about 28,170 prostate cancer deaths. About 1 man in 6 will be diagnosed with prostate cancer during his lifetime. Prostate cancer occurs mainly in older men. Nearly two thirds are diagnosed in men aged 65 or older, and it is rare before age 40. The average age at the time of diagnosis is about 67. Prostate cancer is the second leading cause of cancer death in American men, behind only lung cancer. 

For a male, the lifetime risk of developing prostate cancer is about 15 percent, but the risk of dying of prostate cancer is only 3 percent. This is because prostate cancer often grows so slowly that most men die of other causes before the disease becomes more advanced.

Most men with prostate cancer may not have any symptoms; symptoms of urinating frequently and difficulty with maintaining a normal flow of urine may suggest an enlarged prostate which does not necessarily mean that there is underlying prostate cancer.

Therefore, screening for prostate cancer is important for detection at an early stage.  Prostate-specific antigen (PSA) testing has revolutionized prostate cancer screening. PSA levels can be affected by age and race; these factors are taken into consideration when interpreting abnormal values.

Digital rectal examination (DRE) has long been used to diagnose prostate cancer. Abnormal prostate findings include nodules, asymmetry, or unusual hardening of the prostate. While DRE is a good test to detect cancer when a nodule is found on exam, an absence of nodule does not necessarily rule out prostate cancer.

PSA and DRE are somewhat complementary, and their combined use can increase the overall rate of cancer detection.  However, both PSA and DRE have false positive and false negative rates, and the results of each should be discussed with your physician.

Screening should be discussed with men beginning at age 50, although for men who have life expectancy less than 10 years, screening for prostate cancer may not be necessary as other health problems may determine their life expectancy.

Dr. Johl is Board Certified in Medical Oncologist and Hematologist.  He practices with Diablo Valley Oncology/Hematology Medical Group, located at the California Cancer and Research Institute in Pleasant Hill and also sees patients in Brentwood.  Dr. Johl can be reached at 925-677-5041.