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Prostate's Big Seven

Written by  Rick Piester

September is Prostate Cancer Awareness Month, a time set aside each year to focus on the disease that is the second largest cancer killer of men in the United States. The good news, however, is that if prostate cancer is caught early, the five-year survival rate is almost 100 percent.

To help observe the special month, we talked with some local experts about prostate cancer, its detection, and its treatment. Here's what they say to help you keep ahead of the game, and possibly avoid prostate cancer.

What are the symptoms of prostate cancer?

Prostate cancer is most commonly diagnosed in a man who has minimal or no related symptoms. The presence of urinary symptoms like urinary frequency, urgency, and slow stream can occur with more advanced disease. Sexual symptoms like erectile dysfunction may also indicate prostate disease and possibly prostate cancer. Early detection with prostate cancer screenings is the key component to diagnosing prostate cancer.

   Claiborne Whitworth, IV, MD
   Urological Associates, Ltd
   Charlottesville | 434.295.0184
   www.cvilleurology.com

If I have prostate cancer, what are the first steps I need to take?

Seek opinions from a multidisciplinary group, including your urologist and both medical and radiation oncologists. Together, these specialists will help you make decisions about your course of treatment based on how aggressive your cancer is and whether or not it has spread.

What is involved in testing for prostate cancer?

Typically screening for prostate cancer involves a combination of a prostate specific antigen (PSA) blood test and a digital rectal exam (this exam involves having a lubricated, gloved finger inserted into your rectum to feel part of the prostate gland).

At what age should men begin getting a prostate exam?

This remains a very controversial subject. In general, screening for prostate cancer is not recommended in men younger than 55 unless a man is at an increased risk to develop prostate cancer. Groups at higher risk for prostate cancer are men with fathers, uncles or brothers with prostate cancer or African-American men. Men in these higher-risk groups should discuss the role of screening with their physicians.

   Robert Dreicer, MD, MS, FACP, FASCO
   University of Virginia Cancer Center
   Charlottesville | 434.924.1775
   www.uvahealth.com
   Deputy Director, University of Virginia Cancer Center
   Co-Director, Paul Mellon Urologic Cancer Institute

What are the different types of self-examinations for prostate cancer that I should be aware of?

There are no self-examinations that patients can do at home to screen for prostate cancer. Your doctor can perform screening tests such as a blood test called a PSA (prostate specific antigen) and a digital rectal exam (to feel the prostate), but these tests are often not appropriate. If you are concerned about prostate cancer, the decision of if, and how, to screen for prostate cancer should be discussed with your doctor.

   Andrea Tribastone, MD
   Sentara Forest Lakes Family Medicine
   Charlottesville | 434.654.4600
   www.sentara.com

Am I at a higher risk for developing prostate cancer based on my race?

There is a significant disparity in prostate cancer rates between races. African Americans are 1.6x more likely to be diagnosed than White males and 2.4x more likely to die of the disease. On the other hand, Hispanics and Asian Americans are less likely be to diagnosed during their lifetime. Several possible explanations for these differences include genetic variants between races, screening techniques and variable access to health care. Although mortality rates from prostate cancer have declined in recent years due to improved treatments and screening tools, African Americans are more likely present with advanced disease at diagnosis.

   Brian Stisser, MD
   Blue Ridge Urological, PC
   Fishersville | 540.932.5926
   www.blueridgeurological.com

Can prostate cancer be prevented?

Unfortunately, according to the American Cancer Society, prostate cancer cannot be prevented because these risk factors (age, race, and family history) cannot be controlled. But there are some things you can do that might lower your risk of prostate cancer. Keeping healthy servings of fruits and vegetables in your diet, staying physically active, and maintaining a healthy weight can help lower your risk of prostate cancer. Schedule a visit with your local provider to make sure you are on the right track.

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