Prostate Cancer Information and Resources

Prostate cancer is the most common cancer in men. Screening with PSA has caused earlier detection of prostate cancer. Early stage disease is best treated with radiation therapy or surgery. Learn more about prostate cancer by reading the frequently asked questions below.

Important Questions and Answers about Prostate Cancer (answered by Dr. Matthew Witte - urologist with Urology Specialists Chartered in Sioux Falls)

At what age should men start being concerned about prostate cancer?
We recommend that most guys start being screened at age 50, unless they have a family history of prostate cancer, or they are African-Americans, in which case screening should begin at age 40.

What does a screening involve?
Two things, a blood PSA test, and also a digital rectal exam. The reason we do both is that in 15 percent of prostate cancer diagnoses, men will have normal PSAs but abnormal rectal exams. On the other hand, there are also plenty of people with normal rectal exams who are diagnosed with cancer based solely on their PSAs.
 
What is a PSA test?
It's a blood test to check levels of PSA (prostate-specific antigen), a protein that's made by the prostate. PSA tends to be elevated in cases of prostate cancer, but there are other benign conditions that cause it to be elevated, such as an enlarged prostate or an inflammation of the prostate. That is why it's not the optimal screening test, but at this point it's the best thing we have.

Do most men get the recommended screenings?
Prostate screening is generally part of a man's preventative health care. We do know there's probably a drop-off based on socioeconomic class and race in the percentage of people who get screened. Also, men in general are probably not quite as diligent as women in terms of getting their health care maintenance issues addressed.

How common is prostate cancer?
Prostate cancer is the most frequently diagnosed cancer in men. It's estimated that in 2007, more than 218,000 new cases of prostate cancer will be diagnosed.

What exactly is prostate cancer?
Tumor cells that arise from the prostate tissue. The prostate gland's main function is to provide the fluid for the male ejaculate.

What are the key risk factors?
Age is the major risk factor, as more than 65 percent of all prostate cancer cases are diagnosed in men age 65 and older. Other risk factors include family history and race, specifically African-American. Also, diets high in animal fat have been implicated for prostate cancer risk.

How serious is prostate cancer?
The key to any cancer prevention is diagnosis prior to it spreading beyond the organ where it begins. Clearly if we diagnose it early and the cancer still confined to the prostate, it's a very treatable malignancy. We do see a fairly significant number of people who die from prostate cancer - 25,000-30,000 annually. Once the cancer gets outside of the prostate, it's difficult to eradicate.

What are the symptoms of prostate cancer?
Prostate cancer that has not progressed is rarely symptomatic. When it's progressed to late-stage disease, we start seeing symptoms such as bone pain, or obstruction of the urinary tract, although that is more likely caused by benign prostate enlargement.

How is it treated?
That depends on the individual - their age and the aggressiveness of the cancer. For some people, we do an active surveillance, which means watching and waiting. Common treatments include surgery; brachytherapy, which is radioactive seed implants in the prostate; external beam radiation; or cryotherapy, which involves the freezing of prostate tissue. Hormone therapy, or androgen deprivation, may be used if there's a recurrence after treatment.