Prostate Cancer Q&A with Dr. Kane
There are more than 217,000 new cases of prostate cancer each year. The American Urologic Association now recommends that men be screened for prostate cancer at age 40, rather than 50.
Q: Where do you stand on regular screenings?
- More than 30,000 men die from prostate cancer each year in the United States.
- If you get screened, you can get treatment, if needed.
- Screening is gaining information about whether or not a person has prostate cancer and, if they do, the stage, grade and severity of the disease.
- Most men who are diagnosed young are diagnosed at a stage where they can be cured, experience fewer side effects and are more likely to benefit from treatment.
Q: What are the most important tests for screening prostate cancer?
- I recommend every man know his health stats.
- Be proactive and track your PSA, cholesterol and blood pressure every year.
- PSA stands for prostate specific antigen — a fluid which is present in the semen.
- Elevated levels of PSA in blood serum are associated with benign prostatic hyperplasia (prostate enlargement) and prostate cancer.
- A test for PSA may be used to screen for prostate cancer and to monitor treatment of the disease.
Q: Is there an average PSA for all men?
- One of the popular misconceptions is that a normal PSA is anything under four. This is not true for everyone.
- PSA must be used in the context of age and ethnicity. An average PSA for a man in his 40s is about 0.8 nanograms per milliliter. An average PSA for a man in his 50s is about 0.9-1.0 ng/ml and really should be under 2.5. PSA velocity – the rate of change of PSA – is a very strong predictor of prostate cancer.
- PSA velocity is also correlated with grade and severity of cancer.
- A PSA history that suddenly changes is a more valuable indicator of disease than a single elevated PSA.
Q: Why do men opt for robotic surgery to have the prostate removed?
- Robotic surgery is a tool to perform laparoscopic surgery with a magnified camera and precise instruments.
- For experienced surgeons, robotic surgery has similar cancer control, urinary function and sexual function to a well-performed open radical prostatectomy, but with smaller incisions, less pain, fewer urinary tract scars and less blood loss.
- Robotic surgery does require extensive experience to master - Patients should do their homework before choosing a surgeon.
Q: Is it true that you can have prostate cancer and not need treatment?
- It’s true that there are some men with very low risk, low grade prostate cancer who may not need to be aggressively treated. That’s an important decision they need to make with their physician. However that’s the minority: 15 to 20 percent of newly diagnosed men who have that very low grade, low volume, low PSA, slow-growing form of prostate cancer.
- There are also men who are older or who are in poor health where it is less important to diagnose what is often a relatively slow-growing cancer.
Q: What new medical therapies are on the horizon?
- There are a lot of exciting new treatments for men with prostate cancer.
- There is a new immune therapy called Provenge, which has been in the news.
- Moores Cancer Center has a clinical trial open for select men to receive immune therapy prior to surgery.
- There are also a number of clinical trials examining advances in radiation therapy for prostate cancer patients.
Q: Are there ways to prevent prostate cancer?
- A low-fat, heart-healthy diet may help prevent prostate cancer.
- There is some new information that some medications – finasteride and dutasteride – may prevent prostate cancer, but there are side effects and costs, so a patient should discuss that very carefully with his doctor prior to taking medication for prevention.