Prostate Cancer Awareness Month

By: Joel Braver, M.D., Board Certified Radiation Oncologist and Clinical Instructor, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School and Robert Wood Johnson University Hospital Somerset

According to the American Cancer Society, one out of every seven men will be diagnosed with prostate cancer. This makes prostate cancer the second most common cancer among men behind skin cancer. Today, there are over two million prostate cancer survivors in the United States. The sooner the cancer is identified, the more treatment options are available. September marks National Prostate Cancer Awareness Month, making now a good time to understand the disease and best protect yourself and your loved ones. Take the time to learn more about the facts surrounding prostate cancer.

What are the risk factors?

While it appears that prostate cancer runs in some families, most prostate cancers occur in men without a family history of the disease.

It is rare for men younger than 40 to develop prostate cancer, but the chance increases significantly after age 50. This is why screening for men of average risk should begin at age 50.

African Americans and men who have a father, brother or son diagnosed with prostate cancer when they were younger than 65 are at high risk for developing the disease. Screening for these men should begin at age 45. Men with more than one of these close relatives diagnosed before age 65 are at even higher risk. These men should be screened beginning at age 40.

What are the signs and symptoms?

Early on, prostate cancer does not exhibit any signs or symptoms. However, prostate cancer in a more advanced stage can sometimes result in:

· Issues urinating (slow or weak urinary stream or need to urinate more frequently, especially at night)

· Presence of blood in urine or semen

· Erectile dysfunction

· Hip, back (spine) or chest (rib) pain

· Weakness or numbing sensation in the legs and/or feet

· Loss of bladder or bowel control as a result of cancer pressing on the spinal cord

What are the screening options and when should I be screened?

There are two primary screening options that can be used to aid in the detection of prostate cancer. The prostate produces a protein called prostate-specific antigen (PSA) in the person’s blood. For this test, a small amount of blood is drawn and the level of PSA is measured. Most healthy men have levels under 4 nanograms per milliliter of blood. However, each person is different and the PSA level naturally increases with age, so a lower PSA level does not necessarily guarantee a man is free of cancer, and a higher level does not necessarily mean he has cancer. Another screening option is the digital rectal exam (DRE). During this procedure, a physician will insert a gloved, lubricated finger into the rectum to feel for any bumps or abnormalities on the prostate that may need to be tested for cancer. This test may be done with the PSA or the PSA may be done alone.

It is important that men learn as much as they can about the risks and benefits associated with prostate cancer screenings and discuss this information with a physician before deciding whether to be tested at all. Men at average risk of prostate cancer should speak with their physicians about prostate cancer starting at age 50. Men at higher-than-average risk should speak with their physicians starting at age 40.

What are the treatment options available?

Prostate cancer is usually a slow growing disease and in many cases, treatment may not be needed. These patients will need to be followed closely to make sure their disease is not progressing. If treatment is needed, there are a number of treatment options available. Potential treatment options include surgery and a number of types of radiation therapy.

RWJUH Somerset and New Brunswick are utilizing a new, extremely precise, high-dose form of radiation therapy for prostate cancer called stereotactic body radiation therapy (SBRT) for men with low and intermediate risk of prostate cancer. SBRT uses innovative imaging technologies combined with a sophisticated computer system (similar to the CyberKnife® system) to deliver intense doses of radiation to prostate tumors with extraordinary accuracy, minimizing damage to healthy tissue. SBRT can deliver treatment in 10-minutes or less, and the entire treatment may be completed in as few as five sessions.

Prostate cancer treatments do have potential urinary, bowel and sexual side effects that may seriously affect a man’s quality of life. It is important that candidates for prostate cancer treatment learn about all of the treatment options available by speaking with their physician before making any decisions.

If you are of the appropriate age to be pursuing prostate cancer screenings, consider speaking to your physician during your next appointment or sooner, especially if you are noticing any potential signs or symptoms. Early detection plays a critical role in increased survivorship.

Are free screenings available?

During National Prostate Cancer Awareness Month, many health institutions offer free screenings to their local communities.

In Central New Jersey, interested individuals can schedule a free prostate cancer screening at RWJUH Somerset where screenings will be offered on Saturday, September 24 from 9 a.m. to 11 a.m. and Wednesday, September 28 from 2 p.m. to 5 p.m. at the Somerset campus located at 110 Rehill Ave., Somerville, N.J. The free screenings will include a PSA blood test and an exam by a urologist. This screening is open to men who have no personal history of prostate cancer and who are age 40 and over as well as men age 35 and over who are at high risk. Participants will be required to complete a questionnaire as part of a research study. Pre-registration for this screening is required. To schedule an appointment, call 908-685-2814.

To learn more about RWJUH, please visit www.rwjuh.edu. For a referral to a physician affiliated with RWJUH, please call 1-888-MD-RWJUH. Follow us on Twitter at www.rwjuh.edu/twitter and Facebook at www.rwjuh.edu/facebook.