Staying Ahead Of The Odds
If you already know, or find out, that your hereditary background offers clues to your personal increased chances of prostate cancer, there are powerful resources for detecting it early and characterizing it genomically. If you know youre at risk genetically, start with an annual PSA test that includes all PSA variants, and regardless of your age, and talk to your doctor about having a baseline multiparametric MRI scan of the prostate. This gives you and your doctor a detailed 3D anatomic portrait of the prostate gland and surrounding area, and provides valuable information about the characteristics of tissue in each of the prostate zones. Together, both tests serve as a basis for comparing future blood tests and, if indicated, subsequent mpMRI scans. Note that there are a minority of dangerous PCa cell lines that do not cause an increase in PSA, so request information about additional tests for blood or urine biomarkers.
NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.
Ornish, Dean. Changing your lifestyle can change your genes. PAACTUSA. Dec. 3, 2015.
When Prostate Cancer Risk Is All In The Family
Your familial risk of prostate cancer is greatest if you have a first-degree relative who had the disease, especially if they were diagnosed at a relatively young age. Having multiple first degree relatives with prostate cancer also increases risk. Having multiple second-degree relatives and third-degree relatives adds to the risk, Carroll explains. Its more concerning when we see all cancers on one side of the family, in one blood line, she adds.
In one study, researchers found that men with a brother who had prostate cancer were more than twice as likely as men in the general population to be diagnosed with the disease themselves, and they faced nearly twice the risk of developing aggressive prostate cancer by age 75. Also, men with both a father and brother who had prostate cancer faced about a threefold greater risk of prostate cancer and developing aggressive disease by age 75 compared with the general population.
What Is The Gleason Score
So, how do you know where your biopsy stands? Your biopsy samples will be assigned whats called a Gleason score, the most commonly used way to grade prostate cancer, which will help your doctor make treatment decisions.
It works like this:
Your doctor compares each of the tissue samples taken during your biopsy to normal, healthy prostate tissue.
He or she gives each sample a score, or grade, ranging from 3 to 5.
The more abnormal your cells, the higher your grade. A 5 represents the most aggressive cancer.
Once each sample has been graded, your doctor then takes the two most common scores from all the samples and add them together. These two numbers are then weighted for prevalence. This is your Gleason Score, which can range from 6 to 10, with 10 being the most aggressive cancer.
To make it super clear, lets walk you through an example.
Lets say a man has a biopsy in which 12 tissue samples are removed from his prostate.
After careful study in a lab, each tissue receives a score. Eight of the tissue samples score a 3, while the other four samples each receive a 4.
His doctor then writes the two most common scores, 3 and 4, as the final score: 3+4=7. He writes 3 first because more of the slides were graded as a 3, thus giving these readings more significance.
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How Do Doctors Know If Prostate Cancer Has Spread
If you are diagnosed with prostate cancer, you may need to undergo further testing to determine whether it has metasticized beyond your prostate to other parts of your body.
Computed tomography scans. This type of scan uses X-rays to create detailed images from multiple angles. It can be used to determine the size of tumors on your prostate. You also may undergo this if your doctor suspects that your cancer has spread beyond your prostate to nearby lymph nodes.
Bone scans. When it spreads, prostate cancer often affects the bones. To see if this has happened, you will be injected with a small amount of radioactive material that will allow a special type of camera to pick up signs of cancer in your bones.
Additional MRI scans. MRI images can help your doctor determine how far your prostate cancer has progressed, including whether it has spread beyond your prostate to other parts of your body.
Prostate Cancer: A Guide For Aging Men
Prostate cancer is one of the most frequently diagnosed cancers in the world, despite it only being diagnosed in males . In fact, more than 70 percent of men over the age of 80 have some quantity of cancer cells in their prostate.
Its so common that it sometimes doesnt go diagnosed until autopsies are performed, though that doesnt mean the cancer is the cause of death. On the contrary, the overall prognosis for men diagnosed with prostate cancer is as positive as you can get when talking about the dreaded c word. The five-year survival rates for the disease are close to 100 percent, especially when talking about prostate cancer that is caught early on in the processbefore it spreads.
The five-year survival rates for the disease are close to 100 percent, especially when talking about prostate cancer that is caught early on in the processbefore it spreads.
Nevertheless, prostate cancer is serious business, and the best way to handle a diagnosis is to be informed. Lets take a look at the frequency at which its diagnosed, how youre tested for it, how it can affect your daily life, and what we can do to try and prevent the disease.
Average Age of Prostate Cancer Diagnosis
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Everyone Older Than 60 Has Cancer
Doctors are finally realizing that most people have cancer in their body. But its latent or hidden cancer. Latent cancers are so well contained by the immune system that they never get large enough to cause problems. As a result, doctors rarely discover them, unless they discover them by accident. Most of the cancers they discovered in this autopsy study were latent cancers. And, as you can see, they are very common.
Autopsy studies on women, for example, show that by the time a woman is 40 years old, the chance of her having a latent breast cancer is 40 percent.
That sounds terrible, doesnt it? Its really not terrible. In fact, the existence of latent cancers is very reassuring. They clearly demonstrate how effective a healthy immune system can be in stopping cancer.
Its so effective that the great majority of latent cancers never go on to become full-blown cancers. Thats good news. When you start to add up all of the various autopsy studies that are published, you soon realize that every single one of us over the age of 60 has cancer. Actually, we have at least two of these cancers already living in our bodies. But the really important thing about latent cancers is that they can teach us a lot.
The first thing they teach us is that by maintaining a healthy immune system, we can dramatically decrease our chances of dying from cancer.
Whats the best way to do this?
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Should Men At Elevated Risk Be Screened More Aggressively
It might sound logical to screen high-risk men earlier or urge men to adopt a healthy lifestyle to lower their risk for prostate cancer, but these areas have not been studied sufficiently. Therefore, physician organizations recommend more research and individualizing decisions about whether to get screened. Meanwhile, some leading organizations have issued recommendations, including:
- The American Urological Association The AUA recommends individualizing decision-making for men younger than age 55 who are high risk because they are African-American or have a positive family history. ” rel=”nofollow”> 7)
- The U.S. Preventive Services Task Force The USPSTF largely agrees largely with AUAs position and its 2018 recommendations are based on AUAs evidence review.
- The American Cancer Society The ACS takes this a step further, urging discussion about screening begin earlier for African-American men and men with first-degree relatives who have had prostate cancer.
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What Are The Most Common Second Cancers
You can get any type of second cancer, even in parts of the body far from the prostate. These cancers are among the most common:
Bladder cancer. Most bladder cancers start in cells in the deepest lining of your bladder. Cancer that grows into or through other layers is more advanced and harder to treat. If your doctor finds and treats the tumor early, you have a better chance of a good outcome.
Bloody urine is one of the first signs of bladder cancer. You may see just a little or enough to turn your urine pink, orange, or darker red. The blood might go away for weeks or even months. But itâll come back if you have bladder cancer.
Keep in mind that many things can cause blood in your urine, including infections and kidney stones. Bladder cancer is much less common. Still, you should get checked if you see it, especially if you have trouble peeing or pee more than normal.
You should also be on alert for symptoms of bladder cancer if you had radiation to your prostate. Your bladder lies close to the prostate and can be affected by radiation treatments.
To help lower your risk:
- Donât smoke.
- Drink plenty of water.
- Choose a Mediterranean-style eating plan.
Study after study has shown that Mediterranean-style eating lowers your risk of cancer, along with several other conditions. It limits red meat, sugar, and processed foods. Instead, foods like fresh fruits and veggies, oily fish like salmon, and olive oil are recommended.
What Are Prostate Cancer Treatment Side Effects
Some prostate cancer treatments can affect the bladder, erectile nerves and sphincter muscle, which controls urination. Potential problems include:
- Incontinence: Some men experience urinary incontinence. You may leak urine when you cough or laugh, or you may feel an urgent need to use the bathroom even when your bladder isnt full. This problem can improve over the first six to 12 months without treatment.
- Erectile dysfunction : Surgery, radiation and other treatments can damage the erectile nerves and affect your ability to get or maintain an erection. Some men regain erectile function within a year or two . In the meantime, medications like sildenafil or tadalafil can help by increasing blood flow to the penis.
- Infertility: Treatments can affect your ability to produce or ejaculate sperm, resulting in male infertility. If you think you might want children in the future, you can preserve sperm in a sperm bank before you start treatments. After treatments, you may undergo sperm extraction. This procedure involves removing sperm directly from testicular tissue and implanting it into a womans uterus.
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Genetic Testing For Prostate Cancer
You may hear a lot about genetics or genomics. Both terms are related to genes and cell DNA, but they are different. These tests are being used to learn more about the DNA of cancer cells, and link DNA mutations with treatments. In the future, genetic testing may be the first step doctors take when diagnosing prostate cancer.
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Black Men And Their Doctors May Need To Be More Cautious About Active Surveillance
Active surveillance is an approach in which low-risk prostate cancer is not treated with surgery or radiation therapy. Instead, it is monitored very closely for any changes over months or years and treated only if there are signs the disease has progressed. Active surveillance is increasingly the treatment option of choice for low-risk prostate cancer. Many men embrace this approach because it avoids the potential side effects of treatment.
Black men, however, are more likely to develop more-aggressive prostate cancer. Because of that, active surveillance may be less appropriate for some Black men. As with screening guidelines, there is limited evidence to provide guidance one way or the other because Black men have been underrepresented in active surveillance studies as well, Dr. Laccetti says. This question needs to be studied more before we can come to firm recommendations.
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Us Preventive Services Task Force Issues New Prostate Cancer Screening Guidelines
Prostate cancer is usually though not always a very slow-growing cancer that takes a long time to start affecting the body.
Most often, it only causes symptoms when it grows to pinch the urethra or invade the sphincter or other body parts.
In fact, some men with prostate cancer don’t show any signs or symptoms of their illness, the CDC notes.
Half Of Men Over 60 Have Prostate Cancer But Most Die Of Other Causes
A new study looking at the prevalence of prostate cancer in men over 60 years of age found that just about 50 percent of men have the cancer. This statistic isn’t as distrubing as it sounds most prostate cancers never develop into a harmful form of the disease and a large proportion of men will pass away from other causes without their prostate cancer progressing and becoming invasive.
The current study, published in the Journal of the National Cancer Institute, examined 320 men from Russia and Japan who had died at the age of 60 or older between 2010 and 2011. None of the men had been diagnosed with prostate cancer before their death. Men from Russia were used for the survey because they have similar fat intakes and sun exposures compared to North American men. Japanese men were examined because the incidence of prostate cancer is lower in the male population of Japan, most likely resulting in different diet compared to Caucasian North American men.
How often men should be tested for prostate cancer is a topic of debate among healthcare professionals. After all, the bottom line is that most American men will get prostate cancer if they live long enough. But many of them never experience any ill effects from the cancer, and typically die of natural causes having nothing to do with the prostate. And in fact, many doctors believe that prostate cancer is over-treated because not all men progress to a dangerous form of the disease.
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Your Family History: What You Should Do
It isnt always easy to obtain details of your parents and siblings health, let alone that of more remote ancestors. It is important, however, to get as much information as you can about familial health patterns for as far back, and as generationally broad, as possible. There are more internet sites than ever to help trace family genealogy , but many circumstances such as adoptions or lost records due to wars, emigrations, etc. certainly pose obstacles.
Still, it is exciting and enriching to learn about your genetic strengths, and empowering to learn about your areas of vulnerability that you can do something about.
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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Prostate Cancer Mortality Rate In Canada
In recent years Prostate cancer mortality rate in Canada significantly decreases due to better health facilities, new treatment options of prostate cancer and measurements taken by Canadian government to reduce the mortality rate of prostate cancer in Canada.According to some surveys and research data current mortality rate is 6.6 per 100,000 Canadian men.
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Before takeoff, flight attendants tell you to “put your oxygen mask on first” in case of an emergency. They tell you to do this so that you are able to breathe and survive while helping those around you. When it comes to prostate cancer awareness and prevention, knowledge is your oxygen mask. Use this guide to learn the risk factors and what to do about them. Then help others by sharing what you know. You might just save a life. #prostatecancerawarenessmonth
All men are at risk for prostate cancer. Maybe that includes you, your father, your grandfather, your brother, or your son. No matter how healthy, happy, wealthy, or wise, prostate cancer doesnt discriminate, no matter how much we love and care for the men in our lives.
An estimated one in eight men will be diagnosed with prostate cancer in their lifetimes. It is essential for every man to get to know their personal risk factors. They say the best defense is a good offense, and a good offense always has a strategy. If you or a loved one has yet to put a prostate cancer prevention plan in place, theres no time to start like the present.
This September, were helping you get your game plan together. In honor of Prostate Cancer Awareness Month, start with self-awareness. Early detection not only saves lives but gives you treatment options. The longer you wait the fewer choices you have.
Age, Genetics, and Ethnicity
For context, consider the odds:
Know Your PSA Number
Know Your Advanced Screening Options
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