Dr. Elan Diamond, director of urologic oncology at Holy Name Medical Center, tells us why all men are at risk for developing prostate cancer and how one out of every seven men will be diagnosed in their lifetime.
It's called the "silent killer" for a reason. Many men don't find out they have prostate cancer until the cancer has spread, making it much more difficult to treat.
But now, new genetic testing may help predict not only who is at greatest risk, but how aggressive the prostate cancer is.
What is this new test?
Dr. Elan Diamond:
It's called genomic testing, and it looks at the genetic makeup of the cancer to determine how quickly it will grow.
Several such tests have already been approved by the Food and Drug Administration, including Prolaris, Decipher Score, and Oncotype DX.
All three have been shown to improve the ability to detect more aggressive prostate cancers and may be used to help patients make more informed treatment decisions.
Where is the prostate?
Located just below the bladder, the prostate is part of the male reproductive system and is about the size of a walnut. Prostate cancer begins when cells in the prostate gland start to grow in an uncontrolled and disorganized manner.
What causes prostate cancer?
While it's not exactly known what causes the disease, a number of things can increase your risk. The older you are, for example, the more likely you are to develop prostate cancer. Although only 1 in 403 men under age 50 will be diagnosed, this rate rises to 1 in 58 for ages 50 to 59, and 1 in 21 for ages 60 to 69, according to the Prostate Cancer Foundation.
Family history also plays a large role. Men with a brother diagnosed with prostate cancer are twice as likely to be diagnosed, and if you have a father with prostate cancer that risk triples.
Race and ethnicity can also be factors. Prostate cancer occurs about 60 percent more often in African-American men than in white American men, and when it's diagnosed, the cancer is more likely to be advanced.
We've heard so much about the PSA test, how accurate is it?
Since the late 1980s, the most popular screening tool for prostate cancer has been the PSA test. PSA stands for "prostate specific antigen," and it's a protein produced by the cells of the prostate gland. Abnormally high concentrations in the blood may indicate cancer. But despite widespread use of PSA testing, it's not without controversy. Elevated PSA levels don't always indicate cancer and low PSA levels don't always ensure the absence of cancer. This conflicting evidence often leaves many middle- aged men conflicted as to whether or not to get screened. Even if they do, the vague results can make it difficult to identify which men need rapid treatment and which can take a more wait-and-see approach. Men older than 55 should have a conversation with their doctor as to whether PSA screening is right for them.
How often should I get screened?
According to the American Cancer Society, men should explore the benefit of being tested starting at age 50. In addition, I recommend taking some preventative steps to reduce your risk of prostate cancer. This includes eating a low-fat diet, exercising regularly to maintain a healthy weight, and avoiding smoking and excessive drinking.
Is a prostate cancer diagnosis a death sentence?
A prostate cancer diagnosis can be overwhelming, but it is not a death sentence. Newly diagnosed patients should see a medical oncologist who specializes in prostate cancer to discuss the wide array of available treatment options. Genomic testing may help to provide a clearer path, helping patients to make choices that will lead to the best possible outcome. While genomic testing is still in its early days of clinical use, the hope is that it will usher in a new era in prostate cancer care and help silence this silent killer.
The physicians and staff in the Patricia Lynch Cancer Center at Holy Name Medical Center have one mission: to cure patients of cancer using the most advanced treatments administered in a personalized, compassionate environment.
If you are someone you love are at risk of prostate cancer and would like to make an appointment for screening, please call 201-541-5900 or visit our website, holyname.org/cancercare.