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Friday, September 1, 2023

September is Prostate Cancer Awareness Month; American Cancer Society provides info on prevention, risk and treatment

By Melissa Patrick
Kentucky Health News

When prostate cancer is detected early, the odds of survival are high. That is the message being spread far and wide in September, which is Prostate Cancer Awareness Month. 

Prostate cancer is the second leading cause of cancer death among men in the United Statesm and Black men are two times more likely to die from it than white men. Black men having the highest death rate for prostate cancer of any racial or ethnic group.

According to the American Cancer Society, more than 288,000 men will be diagnosed with the disease this year, with close to 35,000 deaths. 

The good news is that more than 3.5 million men diagnosed with the disease in the U.S. are still alive today, the ACS reports.

The incidence rate for prostate cancer in Kentucky is 108 cases per 100,000 people, with 28 counties having the highest rates of  between 112.6 and 153.3 cases per 100,000 people. The statewide rate is  below the national rate of 109.9 cases per 100,000 people. 

The death rate for prostate cancer in Kentucky is 18.1 per 100,000, with 24 counties having the highest rates of between 22.5 and 44.9 deaths per 100,000 people. This is about the same as the national rate of 18.8 deaths per 100,000 people. 

For Prostate Cancer Awareness Month, Dr. Lorelei Mucci, director of strategic research partnerships at the ACS, provided information in an ACS news release about the signs and symptoms of prostate cancer,  risk factors, screenings and more.

Prevention: Mucci stressed the importance of Prostate Cancer Awareness Month as a way to promote prevention, early detection and treatment to improve survivorship. In addition, she said it's important to set aside time to reflect on those who have been impacted by prostate cancer and those who have lost their lives to it. Further, she said increased awareness of the disease can prompt officials to invest in more prevention and treatment opportunities. 

Warning signs of prostate cancer: "For some men, prostate cancer may lead to urinary problems, such as having difficulty starting urination or urinating frequently, or pain during ejaculation. This is because of the location of the prostate close to the bladder and urethra. These symptoms and signs also occur with non-cancer conditions, so it is important to follow up with a physician to find out what might be causing these symptoms.

"If a cancer has already grown beyond the prostate, there may be pain in the hips, back, or other areas that does not go away. For most people, however, there are no signs or symptoms indicating prostate cancer and the cancer is diagnosed with a biopsy following an abnormal blood test," she writes. 

Who is at risk: Anyone with a prostate is at risk of prostate cancer. 

However,  she writes that ACS research shows that Black men and those of African ancestry are 70% more likely to be diagnosed with prostate cancer. And, the risk of prostate cancer gets higher with age. In addition, people with a family history of prostate cancer (such as in their brother or father) as well as a family history of breast cancer in a sister or mother, are at higher risk of prostate cancer. 

That said, Mucci notes that "maintaining a healthy body weight, not smoking, and being physically active can help to offset this higher risk." 

Treatment and advancements: "There are effective treatments for prostate cancer," she writes. "When the cancer is still confined to the prostate (localized), surgery (radical prostatectomy) and certain forms of radiation are useful to treat and cure prostate cancer. For men who have a low risk of their prostate cancer metastasizing, active surveillance - in which a patient is closely monitored for signs of cancer progression - can also be an important treatment to consider. When the cancer is more aggressive, there are additional therapies that are used, including therapies that target hormonal pathways, chemotherapy, immunotherapy, and radiopharmaceutical therapies. "

"In fact, this is an exciting time in prostate cancer with substantial progress in the discovery and approval of new therapies over the past 5-10 years, as well as several other therapies being developed," she writes. 

Screening test: The main screening test for prostate cancer involves taking a blood sample and testing it for the level of a marker called prostate-specific antigen (PSA). Higher levels of PSA in the blood can indicate prostate cancer, but also may be higher in benign conditions such as an enlarged prostate, so it is important to follow up with a doctor to discuss the results and the next steps. 

She adds that while there is good evidence showing that regular PSA screening can reduce prostate cancer mortality, there is some controversy with screening for prostate cancer since the test can pick up slower-growing cancers that will never lead to harm. She said researchers are working on more effective screening approaches. 

When should you get screened? The ACS recommends that men at average risk for prostate cancer discuss the benefits and limitations of screening with their healthcare provider at age 50.

Men at high risk (which includes Black men in general and any man with a first-degree relative who had prostate cancer before age 65) should have the conversation at age 45. 

Black men with a family history of breast, ovarian, or prostate cancer, and men with more than one first-degree relative who had prostate cancer at an early age should discuss screening at age 40.

"Detecting prostate cancer early can lead to more effective treatment and improved outcomes," she writes. 

In response to the question, "What is the ACS doing to combat prostate cancer?" Mucci said they have established the "Improving Mortality Toward Prostate Cancer Together" (IMPACT) initiative, which she leads. 

She writes, "This cross-institution initiative will address urgent unmet needs with the goals of significantly improving outcomes for all men including survivorship and survival; reducing disparities; improving diversity in prostate cancer clinical trials; accelerating engagement and awareness and accelerating the implementation of known prevention strategies into at-risk communities." 

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