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Shelley: September is Prostate Cancer Awareness Month. According to the CDC, prostate cancer is the second most common cancer in men in the United States. It is also one of the leading causes of cancer deaths in men. We contacted Dr. David Moore, a Deaconess urologist, to help us understand what to look for. What are the symptoms that men should look for in prostate cancer?
Dr. Moore: In general, prostate cancer is asymptomatic. Most men with prostate cancer have been found due to screening. Before the era of screening, men had obstructive symptoms, not having to pee, or even metastatic symptoms where they had prostate cancer that had spread to their bones. Nowadays, generally, prostate cancer has no symptoms and is only manifested by screenings.
Shelley: I'm sure this creates a barrier to getting cancer early because I know of one type of cancer, early treatment is vital for survival, is it the same for prostate cancer?
Dr. Moore: Yes, absolutely. There has been a lot of controversy with PSA testing. PSA is the blood test that detects prostate cancer and, at its introduction, has reduced prostate cancer mortality by 50%. So, many lives of men have been saved. The corollary of this was that many men were receiving excessive treatment or prostate cancer while this may have never had an impact on their lives. Today, our approach to prostate cancer screening is as follows: we like to choose the right men to screen for, those who would benefit from treatment for prostate cancer when it was found .
Shelley: So who are the good guys to track down?
Dr. Moore: The recommendations of the American Urological Association are for men aged 55 to 69, men. We do not universally recommend that everyone be screened because there are risks associated with screening, such as the need for a prostate biopsy or excessive treatment. These men who should sit with their doctor to discuss the relevance of these screening tools. Some men like African-American men or men with a family history of prostate cancer would certainly benefit from screening.
Shelley: You say it's so important because do we really know what causes prostate cancer? If it is in your family, you really need to start screening early.
Dr. Moore: We do not understand what causes prostate cancer. It is certain that a lot of research is going on and must be done in the future. Maybe one day we will identify a specific gene or virus associated with prostate cancer, but so far we only know patterns. Men who have prostate cancer in their brothers or in their fathers or in anyone in their family, or a history of certain mutations in their genes, such as the BRCA mutation, have a history of breast cancer and ovarian in their family. We know that these men are also more exposed.
Shelley: Do I understand you correctly, that if a man has a mother or a BRCA gene, which is a breast cancer gene, it is more likely that they have prostate cancer?
Dr. Moore: Yes, they can. Some types of mutations are also associated with prostate cancer, so these men may also benefit from prostate cancer screening sooner or later in their lives.
Shelley: So, I think that's really the theme here, no matter what your age, you should have the discussion with your doctor, and you can decide if you need to be screened now or if you need to. Wait for that.
Dr. Moore: Yes, it is imperative that you have this discussion and that the screening be offered to you if it is convenient for you, and if you have high PSA we would have gone directly to the prostate biopsy. have plenty of other tools to appreciate the imaging tests or the MRI to better identify the men who could benefit from a prostate biopsy.
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(This story was published on September 7, 2018)
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