“If you wait for symptoms, none of those people will be cured.”
That's why screening men for prostate cancer is so important – there are usually no symptoms in the early stages, said Dr. John Okerbloom, oncologist at Heartland Oncology and a prostate cancer survivor.
Prostate cancer is second only to skin cancer in its prevalence among men older than 50, according to the American Cancer Society. It is also the second most deadly cancer among U.S. men, after lung cancer. This year, an estimated 238,000-plus men will be diagnosed with prostate cancer, and nearly 30,000 of them will die from it.
However, there is disagreement on who should be tested. The American Cancer Society recommends that men have a conversation with their physicians at age 50 about whether to be screened – age 45 if they are in a high-risk group. Methodist Jennie Edmundson Hospital encourages men 40 years or older to get tested – especially those who are at higher risk due to family history, are of African-American descent, or have limited or no health insurance.
Okerbloom recommended men talk to their physicians about whether to be screened for prostate cancer at age 50 – or, if someone in the family has had it, 10 years younger than the age at which the youngest family member was diagnosed.
“My bias is that younger men ought to be tested, because they have more years of life ahead of them – and younger men tend to have more aggressive cancers,” he said.
Testing takes the form of a prostate-specific antigen blood test or a digital rectal exam by a physician. Neither is 100 percent accurate and can result in a false positive or a false negative, according to the American Cancer Society.
Prostate cancer occurs mainly in older men. About 60 percent of cases are in men 65 or older, according to the American Cancer Society website. In addition, it is usually slow-growing. So the decision of whether to be treated – or even tested – can be a difficult one. Treatment is done through surgery or radiation and can cause urinary, bowel or sexual side effects that affect a man's quality of life, the American Cancer Society says. For some older men, it might not be worth the trouble.
But that decision would be easier to make if doctors could tell how aggressive the cancer was. “We haven't made much progress” on being able to determine that, Okerbloom said. “We need the genetic markers that hopefully will tell us that. The idea is that they will be able to look at the genetics of the tumor cells” and determine how “mean” the cancer is.
We don't have that ability yet, but it's coming, he said.
When symptoms do show up, they can include:
• Problems urinating, including slow or weak urinary stream or a need to urinate more often, especially at night. This can also be caused by benign prostate hyperplasia.
• Blood in the urine
• Pain in the hips, back, chest or other area, if cancer is in the bones
• Weakness or numbness in the legs or feet or loss of bladder or bowel control from cancer putting pressure on the spinal cord
In Okerbloom's case, it was something most people don't associate with prostate cancer.
“I was having back pain,” he said.
He had an MRI for his back, and doctors noticed that his lymph nodes were enlarged, he said. The cancer was traced back to his prostate. Because it had entered his bones, he has been receiving hormonal therapy since his diagnosis in May 2005.
For more information on prostate or other cancers, visit cancer.org.
Men 40 years or older are encouraged to get tested, particularly those who are at higher risk because of family history, are of African-American descent or have limited or no health insurance. Pre-registration is required. Any previous diagnosis of prostate cancer excludes individuals from participating.
This free screening includes a prostate examination by a physician, prostate-specific antigen blood test and educational materials. Results will be mailed directly to the patient and his physician.
Advanced registration for the free prostate screening is required. Call Methodist Jennie Edmundson's Patient Scheduling at (712) 396-7600.
– Methodist Jennie Edmundson Hospital