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Prostate Cancer Awareness Month

Scot Ackerman , M.D.

September 15, 2021

Prostate Cancer Awareness Month

Following skin cancer, prostate cancer is the second most commonly diagnosed cancer in American men. According to the American Cancer Society, 1 in 8 men will be diagnosed with prostate cancer in their lifetime. In fact, 248,530 new cases of prostate cancer are estimated to be diagnosed in 2021 alone. Dr. Scot Ackerman joined WJXT yesterday morning to discuss the risk factors for someone who may be at risk of prostate cancer, as well as the screening methods and treatment options that are available.

Although risk factors can increase a person’s chance of getting cancer, having one or more risk factors does not mean you will get cancer. It is important to be aware of the following risk factors in order to remain as healthy as possible.

Risk Factors:

  • Age: Rare in men that are younger than 40, but chance of diagnosis rises rapidly after age 50 and is most common after age 65.
  • Race: Most common in African-American men and Caribbean men of African ancestry. When prostate cancer develops in these men, it typically occurs earlier in age.
  • Geography: Most common in North America, northwestern Europe, Australia, and Caribbean islands. This could be because of more extensive testing in developed countries, as well as lifestyle differences (diet, etc.).
  • Family History: Having a father or brother with prostate cancer more than doubles a man’s risk. When several relatives have been diagnosed, especially at a young age, risk also increases.
  • Genetic mutations: BRCA1 or BRCA2 genes, and Lynch syndrome increase risk.

Symptoms: Prostate cancer in its early stages does not normally cause symptoms, however symptoms can show up in more advanced stages. This is why regular screening and diagnostic testing is so important.

  • Problems urinating- slow/weak stream or constant urination at night
  • Blood in the urine or semen
  • Erectile dysfunction or ED
  • Weakness or numbness in the legs or feet, loss of bladder/bowel control

Screening and Diagnosis:

  • Prostate-specific antigen (PSA) blood test:
    • PSA < 4, man is very likely to not have prostate cancer
    • PSA level between 4 and 10, man has a 25% chance of prostate cancer
    • PSA > 10, man’s chance of prostate cancer is over 50%
    • There is no set cut off point to determine if a man has prostate cancer, because there are many factors that can also increase PSA levels including:
      • Enlarged prostate, age, recent ejaculation, riding a bike, certain urologic procedures (biopsies), certain medicines (testosterone)
    • There are also factors that can lower PSA levels, even if a man does have prostate cancer, including:
      • 5-alpha reductase inhibitors, herbal mixtures, and long term use of certain medications such as aspirin
  • Digital Rectal Exam: Prostate cancers often originate in the back part of the prostate gland, and can sometimes be felt during a rectal exam.
  • Prostate Biopsy: Most commonly performed after an initial PSA test comes back as high.

Treatments: It is important to consider what stage the cancer is when deciding course of treatment. Age, overall health, life expectancy and risk of reoccurrence after treatment can also be considered.

  • Observation- Often considered for Stage 1.  These cancers are small, grow slowly, and rarely cause symptoms. Some men with Stage 2 prostate cancer can also be placed under surveillance and receive regular screening.
  • Surgery- Stage 4 prostate cancers can often not be cured, but can be treated with surgery which relieves symptoms such as bleeding and urinary obstruction.
  • Hormone therapy- Considered for Stage 2 and 3.
  • Radiation therapy- Considered for Stage 1 with men who are young and healthy, and know they may need to be treated again later on. Men with Stage 2 and 3 prostate cancer can also be treated with radiation therapy.
  • Chemotherapy- Commonly considered with Stage 4, in addition to other treatment methods such as radiation therapy.

Survivorship:

While most prostate cancers can be removed or destroyed with treatment, it is very important to continue screening and attend doctors appointments. Most physicians recommend PSA tests after treatment every 6 months for the first 5 years and then 1 time per year after the first 5 years.

To view the full interview with Dr. Scot Ackerman and WJXT, click here

To learn more about the treatment options offered for Prostate Cancer at Ackerman Cancer Center, click here

Sources:

Prostate Cancer | Prostate Cancer Information and Overview

 

 

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