Current Psa Screening Recommendations
PSA-based screening refers to testing healthy men without symptoms.
Until recently, physician societies disagreed on screening recommendations, but with the publication of the U.S. Preventive Services Task Force Guideline in May 2018, all the major physician groups are broadly in agreement, including the American College of Physicians , the American Cancer Society , American Urological Association , and American Society of Clinical Oncology :
- They advise supporting men so that they make informed decisions about screening that reflect their personal preferences and values.
- Routine screening is not recommended in men between ages 40 and 54 of average risk.
- For men ages 55 to 69 years, the U.S. Preventive Services Task Force concluded with moderate certainty that the net benefit of PSA-based screening is small for some men, making the decision up to the judgment of the physician and the values of the patient.â
- For men 70 years and older, they recommend against routine screening because the expected harms are thought to outweigh the benefits.
- Your doctor should not screen you unless you express a preference for it.
- A discussion of the benefits and harms of screening should include a family history of prostate cancer, race or ethnicity, any medical conditions that affect your overall health and lifespan, and your values about risk and benefit.
- If you have less than a 10-year life expectancy, screening is not recommended.
What To Expect From Your Doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may allow more time later to cover other points you want to address. Your doctor may ask:
- When did you first begin experiencing symptoms?
- Have your symptoms been continuous or occasional?
- How severe are your symptoms?
- What, if anything, seems to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
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What To Expect During A Prostate Exam
However, theres some controversy around using 5-ARIs to prevent prostate cancer. Several studies suggest that 5-ARIs may lower your risk, while others proposed the drugs may actually increase it .
In 2018, the U.S. Food and Drug Administration issued a warning against using 5-ARIs to prevent prostate cancer. If youre considering using these drugs, talk to a healthcare provider beforehand about the risks and benefits .
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Prostate Cancer Nutrition And Dietary Supplements Patient Version
On This Page
Complementary and alternative medicine is a form of treatment used in addition to or instead of standard treatments.
In the United States, about 1 out of every 8 men will be diagnosed with prostate cancer. It is the most second-most common cancer in men in the United States. CAM use among men with prostate cancer is common. Studies of why men with prostate cancer decide to use CAM show that their choice is based on medical history, beliefs about the safety and side effects of CAM compared to standard treatments, and a need to feel in control of their treatment.
CAM treatments used by men with prostate cancer include certain foods, dietary supplements, herbs, vitamins, and minerals.
Different types of research have been done to study the use of CAM in prostate cancer. These study types include the following:
CAM treatments have been studied to see if their use lowers the risk of prostate cancer, kills prostate cancer cells, or lowers the risk that cancer will come back after treatment. Most of these studies used prostate-specific antigen levels to find out whether the treatment worked. This is a weaker measure of how well the treatment works than direct measures, such as fewer new cases of prostate cancer, or smaller tumor size or lower rate of recurrence after treatment for prostate cancer.
This PDQ summary has sections about the use of specific foods and dietary supplements to prevent or treat prostate cancer:
Who Should Not Take Finasteride
Do not take finasteride if you:
- are pregnant or may become pregnant. Finasteride may harm your unborn baby. Females who are pregnant or who may become pregnant should not come in contact with broken or crushed finasteride tablets. If a pregnant woman comes in contact with crushed or broken finasteride tablets, wash the contact area right away with soap and water. If a woman who is pregnant comes into contact with the active ingredient in finasteride, a healthcare provider should be consulted. o If a woman who is pregnant with a male baby swallows or comes in contact with the medicine in finasteride, the male baby may be born with sex organs that are not normal.
- are allergic to any of the ingredients in finasteride.
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Atenolol: It Lowers Blood Pressure And It Prevents Prostate Cancer
An April, 2020 paper based on a study of multiethnic men suggests that a drug called Atenolol is a blood pressure medication AND a prostate cancer preventative. Atenolol is one of a class of drugs called beta-blockers that are commonly used to lower high blood pressure and reduce cardiac deaths.
The study involved 4516 African-American and Hispanic men who had an initial prostate biopsy during the period 2006-2016. Overall, 2,129 had a biopsy positive for prostate cancer . Medical records for the previous 5 years showed that 15% of participants were taking a beta-blocker prior to biopsy, and the three most-prescribed drugs were Metoprolol, Carvedilol, and Atenolol.
Only Atenolol made a significant statistical difference in PCa risk levels. Compared with patients who were not on beta-blockers, those on Atenolol had a 38% lower risk of being diagnosed with PCa, with even lower risk reduction of intermediate-risk disease and high-risk disease longer use gave 54% less chance of intermediate-risk PCa and 72% less chance of high-risk PCa.
Surgery To Remove The Prostate
Surgery for prostate cancer involves removing the prostate gland , some surrounding tissue and a few lymph nodes.
Surgery is an option for treating cancer that’s confined to the prostate. It’s sometimes used to treat advanced prostate cancer in combination with other treatments.
To access the prostate, surgeons may use a technique that involves:
- Making several small incisions in your abdomen. During robot-assisted laparoscopic prostatectomy, surgical instruments are attached to a mechanical device and inserted through several small incisions in your abdomen. The surgeon sits at a console and uses hand controls to guide the robot to move the instruments. Most prostate cancer operations are done using this technique.
- Making one long incision in your abdomen. During retropubic surgery, the surgeon makes one long incision in your lower abdomen to access and remove the prostate gland. This approach is much less common, but may be necessary in certain situations.
Discuss with your doctor which type of surgery is best for your specific situation.
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Questions To Ask Your Health Care Provider About Cam
When considering complementary and alternative therapies, patients should ask their health care provider the following questions:
- What side effects can be expected?
- What are the risks related to this therapy?
- What benefits can be expected from this therapy?
- Do the known benefits outweigh the risks?
- Will the therapy affect conventional treatment?
- Is this therapy part of a clinical trial?
- If so, who is the sponsor of the trial?
- Will the therapy be covered by health insurance?
Intermittent Versus Continuous Hormone Therapy
Most prostate cancers treated with hormone therapy become resistant to this treatment over a period of months or years. Some doctors believe that constant androgen suppression might not be needed, so they advise intermittent treatment. This can allow for a break from side effects like decreased energy, sexual problems, and hot flashes.
In one form of intermittent hormone therapy, treatment is stopped once the PSA drops to a very low level. If the PSA level begins to rise, the drugs are started again. Another form of intermittent therapy uses hormone therapy for fixed periods of time for example, 6 months on followed by 6 months off.
At this time, it isnt clear how this approach compares to continuous hormone therapy. Some studies have found that continuous therapy might help men live longer, but other studies have not found such a difference.
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About Dr Dan Sperling
Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.
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To Learn More About Cam
National Center for Complementary and Integrative Health
The National Center for Complementary and Integrative Health at the National Institutes of Health facilitates research and evaluation of complementary and alternative practices, and provides information about a variety of approaches to health professionals and the public.
- NCCIH Clearinghouse
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Selenium Vitamin E And Other Antioxidants
The concept that antioxidants can prevent malignant transformation or treat established malignancy has been reported for many years and previously reviewed . Briefly, this concept is based on the idea that free radicals are able to induce DNA damage that may ultimately lead to mutations that predispose cells to malignant transformation . In humans, the most common free radical is the hydroxyl radical and the term reactive oxygen species is commonly used to encompass all oxygen-containing free radicals.
There are multiple preclinical models in prostate and other malignancies to suggest that antioxidants can prevent malignant transformation and/or delay progression . Antioxidants such as selenium and vitamin E have long been touted, and until quite recently, commonly used by PCa patients with both preventive and therapeutic intent.
What Is The Prognosis For People Who Have Prostate Cancer
Because prostate cancer tends to grow slowly, most men die from something other than the disease. Early detection is key to better outcomes. Almost all men 97% to 98% diagnosed with localized cancer that hasnt spread outside of the prostate live at least five years after diagnosis. When metastatic cancer has spread outside of the gland, one-third of men continue to survive after five years.
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Ask The Doctor: Bph Drugs For Preventing Prostate Cancer
Q. I take Avodart for my enlarged prostate. But I heard that Avodart increases prostate cancer risk. Is that true? Should I quit taking Avodart?
A. You are on the right track about the cancer risk, but it’s complicated.
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South African Rooibos Herbal Tea
Rooibos, which is only found in the Cederberg region of the Western Cape, South Africa, is known for its aromatic flavour. The plant has been found to have anti-cancer properties in in vitro and in vivo animal models.
Additional research shows that the herbal tea possesses ingredients that reduce oesophageal and liver cancer and skin tumours. Clinical trials in humans are being planned.
The Cancer Association of South Africa has endorsed the herbal teas potential as a form of natural chemoprevention. This means it can aid in preventing cancer and even possibly reduce the growth of cancer cells. And it has funded research projects aimed at identifying the active ingredients.
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Other Factors That Increase The Risk Of Prostate Cancer
Besides the above-discussed causes, there are a few other factors that increase the risk of getting affected by prostate cancer:
- Old Age The risk of prostate cancer increases with the increase of age. More commonly, it is diagnosed in men aged 50 or above. Around 60% of prostate cancer occurs in men above 65 years.
- Family History The risk of prostate cancer increases if someone from your family such as your brother, sister, or parents, or child is affected by prostate cancer.
- Geographical Location An increasing number of people around Caribbean Islands, Australia, North-Western Europe, and North America are affected by prostate cancer. South America, Central America, Africa, and Asia are the least common areas where people get prostate cancer.
- Racial Background For some unknown reasons, the risk of prostate cancer is higher in Black race people than other races. There can be a more advanced or aggressive type of this cancer in Black people.
- Obese It is considered that people who are overweight are more prone to get prostate cancer. A person with a healthy weight has a lower chance of getting it. Prostate cancer can also return and be more aggressive in obese people. Therefore, maintaining a proper weight is important to avoid this type of cancer.
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Are There Any Foods I Should Eat Less Of
You may have heard that eating a lot of certain foods may be harmful for men with prostate cancer, including:
- dairy foods and calcium
- red or processed meat
With all of these foods, some studies have suggested they might be harmful for men with prostate cancer, but other studies havent found a link. This means we cant say for sure whether eating less of these foods can help.
Theres no need to cut these foods out of your diet completely. We need more research to fully understand their effect on prostate cancer, but you can still eat most of these foods in moderate amounts as part of a healthy, balanced diet. However, the World Cancer Research Fund recommends avoiding processed meat, as it can increase your risk of some other types of cancer.
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Baking Soda And Molasses
There was a man who had been diagnosed with prostate cancer and given up for dead by doctors. His name was Vernon Johnston. The cancer had metastasized into his bones so things were looking pretty bleak for him. But you know what? He beat the disease and did it using baking soda.
Another guy who did the same is Jim Kelmun. Today, he helps others to do the same. One of the things that make baking soda among my favorite natural cures for prostate cancer is, that it works quickly and effectively and is very easy to prepare.
Heres what to do:
Simply mix up thoroughly 1 teaspoon of aluminium free baking soda with 1½ to 2 teaspoons of black-strap molasses or Manuka honey on a dessert spoon or tablespoon. Take on an empty stomach with one glass of filtered water . Do this twice a day for the first week then increase to three times a day thereafter.
Continue doing this for 4-6 weeks before stopping. After a 4 week rest period, you may then repeat the protocol once again. Avoid all physical activity for at least 40 minutes after taking the mixture, because you dont want your body to be using up the sugars in the syrup for energy. You want the cancer cells to be sucking in the sugar along with the baking soda.
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Treating Advanced Prostate Cancer
If the cancer has reached an advanced stage, it’s no longer possible to cure it. But it may be possible to slow its progression, prolong your life and relieve symptoms.
Treatment options include:
- hormone treatment
If the cancer has spread to your bones, medicines called bisphosphonates may be used. Bisphosphonates help reduce bone pain and bone loss.
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Lycopene: Questions And Answers
Lycopene is a carotenoid . It mixes with or dissolves in fats. Lycopene protects plants from light-related stress and helps them use the energy of the sun to make nutrients. Lycopene is found in fruits and vegetables like tomatoes, apricots, guavas, and watermelons.
The main source of lycopene in the United States is tomato-based products. Lycopene is easier for the body to use when it is eaten in processed tomato products like tomato paste and tomato puree than in raw tomatoes.
Lycopene has been studied for its role in the prevention of heart and blood vessel disease.
Lycopene may be eaten in food or taken in dietary supplements.
For information on laboratory and animal studies done using lycopene, see the Laboratory/Animal/Preclinical Studies section of the health professional version of Prostate Cancer, Nutrition, and Dietary Supplements.
Population studies and clinical trials have been done to find out if lycopene can prevent or treat prostate cancer. Clinical trials have shown mixed results some studies have shown a lower risk of prostate cancer or a decrease in prostate-specific antigen level, and others have not. There is not enough evidence to know whether lycopene can prevent or treat prostate cancer.
Population and combined studies
How Common Is Prostate Cancer And Who Is At Risk
Prostate cancer most often affects men between ages 55 and 69. There is a huge gap between the proportion of men diagnosed with prostate cancer and those whose health and lifespan are affected by the disease. American men have a 16 percent lifetime risk of developing prostate cancer, but only 2.9 percent of men die from it.
In fact, many prostate cancers are believed to be slow growing, with men dying from causes other than prostate cancer. Autopsy studies support this, finding that 30 percent of 55-year-old men and 60 percent of men reaching age 80 on whom an autopsy is performed have autopsy-discovered prostate cancer.
There are some factors that increase risk for prostate cancer, including:
Race Race seems to play a role in the frequency and severity of the disease. African-American men are far more likely to develop prostate cancer than white men 203.5 vs. 121.9 cases per 100,000 men. They are also more than twice as likely as white men to die of prostate cancer 44.1 vs. 19.1 deaths per 100,000 men.
Family History Positive family history of prostate cancer is another risk factor.
Elevated Body Mass Index Elevated BMI is another risk factor, linked to an increased risk of prostate-cancer-specific mortality and biochemical recurrence in men with prostate cancer.
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