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." 

Anchorman Sam Dick retires at Lexington's WKYT-TV; he went public with his prostate cancer, surely saving the lives of others

Sam Dick goes public with his cancer. (WKYT-TV image Tuesday, from broadcast several years ago)

Sam Dick, a familiar face to millions of Kentuckians over a record 34 years as evening anchor on Lexington television, did his last newscast Wednesday night. Thousands of Kentuckians remembered him as the man who used his own case of prostate cancer as a teachable moment that surely saved lives.

The story began with “Three words from my doctor that changed my life,” Dick said. “We found something.” Soon, he shared his journey, through surgery, follow-up tests and, after the cancer returned, radiation treatments.

“The first few times, I was pretty anxious and a little nervous about it,” Dick said in a story by Garrett Wymer, broadcast Tuesday evening on WKYT-TV. “I definitely said some prayers. But after about five or six days of the radiation, I got more comfortable, and actually, I try to take a nap.”

Wymer reports, “He used his platform to open up a dialogue, talking about the importance of annual prostate exams and early detection. . . . It was personal to Sam even before his own diagnosis. His father, David, passed away after a 17-year fight against prostate cancer. He pushed Sam to get annual exams, starting in his 40s.” David Dick was a former CBS News correspondent who directed the University of Kentucky journalism school.

Going public with his story made Sam Dick a resource for other men battling prostate cancer.

Rusty Parsons told Wymer, “Sam’s response was: ‘This is my phone number. Call me.’ We talked and we talked, and I cried. and he said the words that came out of his mouth was: ‘I’ve been through everything you’re going through. You are normal. There is nothing wrong with you.’”

Men, get your prostate checked; early detection is the key to beating cancer, but pandemic is making people put off checkups

By Steve and Heather French Henry, Kristy Young and Melissa Karrer

Cancer screenings save lives among men. But with the ongoing covid-19 pandemic, too many Kentuckians are forgoing or delaying their annual health exams and cancer screenings. By putting off these important doctor appointments, we risk trading one public-health crisis for another. We cannot risk more late-stage cancer diagnoses when most cancers can be found and treated with an early screening measure.

September is National Prostate Cancer Awareness Month. And fortunately, our elected leaders in the Kentucky General Assembly also recognize the importance of these potentially life-saving cancer screenings. During the 2020 legislative session, the General Assembly voted to designate September as Prostate Cancer Awareness Month to encourage early prostate screenings for Kentuckians. The message they intended to send is now more important than ever.

Prostate cancer is one of the leading causes of cancer deaths in the United States. Right here in the commonwealth, 2,681 Kentuckians will be diagnosed with prostate cancer this year alone and 385 men will lose their battle to this life-threatening disease, according to the National Cancer Institute.

Because prostate cancer grows slowly, it is likely to be found in an early stage through a screening test, such as a simple blood test called prostate-specific antigen (PSA) test or digital rectal exam. And the good news is that when caught early, individuals have a 90% chance of survival.

Unfortunately, data shows that urologists are diagnosing prostate cancer at far more advanced stages compared to the last five years. And this means the treatment options become more aggressive and survival rates significantly decrease.

That’s why early detection is key to finding prostate cancer in its earliest and most treatable stage. Even during a health crisis like the one we are currently in, it is important to make sure to take care of your health and talk to your physician about when you should be tested.

The truth is cancer doesn’t stop because of a pandemic. We’re already heading down a dangerous road, as data from the JAMA Network shows a steep reduction in new cancer diagnoses this year compared to last, which means we can expect to see a rise in late-stage cancer.

This is not the time to wait until you have symptoms to visit your doctor. It is safe to do so. And the minimal risk outweighs the potential harm. Early detection is key to beating cancer and saving lives. When we raise awareness about early prostate detection, we are giving more men the opportunity to live long, healthy, cancer-free lives.

Let’s all encourage our fathers, brothers, husbands, family, friends and all Kentuckians to schedule a time to talk to their health care providers about if they should get a prostate cancer test and be screened for other cancers. Their lives could depend on it.

Steve Henry is a physician and former lieutenant governor. Heather French Henry was Miss America 2000. They are with the Kentucky Prostate Cancer Coalition. Kristy Young is with the Kentucky chapter of the American Cancer Society Cancer Action Network, and Melissa Karrer is with the Kentucky Cancer Link.

Want to avoid prostate cancer? Evidence suggests that one thing you could do, if you're a smoker, is to stop smoking

As fewer men are smoking, fewer are dying from prostate cancer, and the trends appear to be related, especially in Kentucky.

"From 1999 through 2010, decreasing prostate cancer mortality rates were consistent with a reduction in cigarette smoking at the population level," says the report, published in the journal Preventing Chronic Disease.

The study looked at four states: Kentucky, with the highest smoking rate (24.8 percent), Utah, with the lowest rate (9.1 percent), and Maryland (15.2 percent) and California (12.1 percent), with average rates.

Researchers found that in Kentucky and Maryland, smoking rates declined by 3 percent and prostate cancer deaths declined by 3.5 percent annually. Among black men in Kentucky, there was little change in the smoking rate or the prostate-cancer death rate.

In California and Utah, smoking declined by 3.5 percent annually, and prostate cancer deaths declined by 2.5 percent and 2.1 percent respectively each year.

The report says current cigarette smoking, rather than past or cumulative smoking, is a risk factor for prostate cancer development, progression, recurrence and death. The U.S. surgeon general named smoking as a cause of prostate cancer in 2014.

Men were classified as current smokers if they reported smoking at least 100 cigarettes in their lifetime and continued to smoke at least occasionally.

The researchers note that these findings do not prove causation, only that the two time trends were similar. They also noted that further studies should be done to include more states.

Louisville doctor is first in U.S. to use ultrasound treatment to treat early prostate cancer; procedure 'has its critics as well as its fans'

Dr. John Jurige with his device. (C-J photo by Matt Stone)

A Louisville urologist is the first in the nation to use ultrasound to treat prostate cancer, a procedure that recently received federal approval but still "has its critics as well as its fans," Darla Carter reports for The Courier-Journal.

"Dr. John Jurige, a longtime local urologist, is treating patients with Sonablate, a device that uses high-intensity ultrasound waves to destroy cancerous prostate tissue," Carter writes. "The outpatient procedure is typically for men with stage 1 or 2 prostate cancer that hasn’t spread and who meet certain other criteria, such as having a relatively small prostate."

Jurige said he has used the treatment on about 400 patients outside the U.S. in the last eight years, and those “who did, in fact, have early stage prostate cancer have done extremely well,” he said.

"But some physicians say the high-intensity focused ultrasound (HIFU) procedure isn't necessarily right for the men it's being pitched to and that it's important for patients to consider all of their options and to, perhaps, seek a second opinion," Carter reports. Dr. Jamie Messer, a urologic oncologist at Louisville's James Graham Brown Cancer Center, told her, “The patients that are really candidates for HIFU for prostate cancer are patients that may be best served with active surveillance,” or close monitoring.

“The type of prostate cancer that HIFU seems to be most effective for is the type of prostate cancer that patients may live for decades with, without any negative consequences, meaning no metastasis (spread) of their cancer, no symptoms from their cancer,” Messer said. “This is the patient we often refer to that will die with their prostate cancer, not from their prostate cancer.”

Carter reports, "Patients turn to the $25,000 procedure not only to eradicate their cancer but to try to avoid unwanted consequences, such as erectile dysfunction and bladder-control issues, that people associate with prostate cancer treatment." Her story includes quotes from satisfied patients.

Study suggests there's too much imaging of low-risk prostate- and breast-cancer patients in the Evansville and Louisville areas

Hospitals and doctors in the Evansville and Louisville areas may be doing too much medical imaging on patients with low-risk prostate or breast cancer, according to a study of cases in the middle of the last decade.

Researchers at New York University examined Medicare records from 2004 through 2007 of 9,219 men with low-risk prostate cancer and 30,398 women with low-risk breast cancer, across 84 of the nation's hospital referral regions. They concluded that unnecessary imaging was done in 44 percent of men and 42 percent of women, they report in the journal JAMA Oncology.

The report did not give rates for each hospital region, but ranked them, and Evansville was second, right behind Slidell, La., and Louisville was 24th. Owensboro was 37th. Other regions listed were Paducah, 45th; Nashville, 57th; and Lexington, 78th. For the study appendix, listing the hospital areas and their rankings, click here.

The study found that "hospitals in the Northeast reported higher use of imaging tests for low-risk patients, while other regions, such as the Northwest and Utah, demonstrated more appropriate use of imaging," an NYU press release said. It quoted Dr. Danil V. Makarov, the lead investigator and professor, as saying, “Policy makers and researchers need to target high-utilization regions and promote incentives for appropriate care. Such a focus would enhance efforts to cut excessive health spending and build value-based strategies into health care practice.”

Imaging for prostate cancer generally involves CT scans or bone scans. Imaging for breast cancer generally involves CT, MR and PET scans.

WKYT anchor Sam Dick finishes radiation treatment for recurring prostate cancer; encourages others to monitor their health

Photo from www.mediabistro.com 

Longtime WKYT-TV anchor Sam Dick believed that his battle with prostate cancer was over, but found out six months ago that some of the cancer remained. He reported on his diagnosis and treatment as he neared the end of a seven-week course of radiation.

"Being told you have cancer is life-changing," Dick said. "Three and a half years ago, many of you followed my journey fighting prostate cancer and were very supportive as I decided to have surgery to remove the prostate. I was told by doctors at the time, I was cured."

But six months ago his prostate specific antigen levels, which had stayed undetectable for two years after his prostate was removed, crept up, so he started daily treatments at Lexington Clinic's John D. Cronin Cancer Center. PSA levels can vary widely and can be unreliable, but are the best diagnostic tool available. "In my case, a rising number means cancer is likely still present," he explained. Dick's treatment was tailored to his medical condition and cancer history.

Dick has maintained his regular schedule of anchoring WKYT's evening newscasts and had told only a handful of people about the cancer's recurrence, but as he approached his last radiation treatment he said he wanted to remind others about the importance of watching for warning signs.

"We can't see the cancer cells in a situation when we're treating for a rising PSA after surgery, but we know where we need to treat because there is an overwhelming likelihood that the reason that the PSA is going up is because there is residual disease in the pelvis so that's our target," Dr. Janalyn Prows, a radiation oncologist, said in the WKYT report.

"It's not uncommon for men who've had their prostate removed because of cancer to find out years later some cancer" remains, but it's not what I expected, or centrality wanted," Dick said.

His father, journalist and author David Dick, battled prostate cancer for more than a decade before dying of it a few years ago. He referred to that and said, "I feel blessed. They had nothing like this available. The advances of medical technology are a blessing I'm taking advantage of, and I'm hopeful and optimistic it's going to work."

Dick will have his follow up PSA in two months. "At that time, we'll see where I am," Dick said. "Until then, I appreciate all the emails, Facebook posts, and notes of support and prayers. Thank you from the bottom of my heart!"

Prostate cancer is the second most common cancer among men after skin cancer, according to the American Cancer Society. For more information about it, click here.

Markey Cancer Center at UK gets National Cancer Institute designation, opening up new treatment options for patients

The University of Kentucky annouced Friday that its Markey Cancer Center has earned a prestigious National Cancer Institute designation. With this designation, the center becomes one of 68 in the U.S., and the only one in Kentucky, with special access to clinical trials, new treatments and new drugs for patients.

Kentucky ranks first in the nation in cancer deaths per 100,000 residents, and cancer is especially problematic in Appalachia, where the overall cancer rate is 12 percent higher than in the United States.

The designation signifies national excellence in clinical care and cancer research, a UK news release said. It allows Markey patients to join specialized drug or treatment trials that are open only to NCI centers, and it also opens up funding for researchers at UK, said Michael Karpf, UK's executive vice president for health affairs.

"It's the ultimate recognition for academic cancer centers," Markey Executive Director Mark Evers said. It will help UK battle cancers that plague the state, particularly lung and colorectal cancers, Evers said in a story by Linda Blackford of the Lexington Herald-Leader. To earn the designation, the center had to pass a rigorous review that began four years ago and will be renewed every five years, says the UK release.

UK officials said the designation will boost the state and local economy through research funding, and advanced cancer research could also generate more high-tech, health care jobs in the state.  "It strengthens Markey’s reputation as a frontrunner in cancer treatment and research," the UK release said.

Federal panel says PSA screening for prostate cancer does more harm than good, but no better test is available

Prostate cancer cells. Getty Images photo by Abbey Michael.

An influential federal panel says testing healthy men's prostate-specific antigen levels to detect prostate cancer does more harm than good.

The PSA test can lead to unnecessary biopsies for men who turn out to be cancer-free. Those biopsies can also lead to men being treated for cancers that are so slow-growing (a characteristic of most prostate cancers) that they didn't need to be detected.

An estimated 1,000 to 1,300 men die annually from complications associated with treatments that are initiated because of PSA screening, reports Alice Park for Time magazine. Moreover, treating harmless prostate tumors increases the chances of making men impotent or incontinent.

The U.S. Preventive Services Task Force published the recommendation in the Annals of Internal Medicine. In 2009, the panel also recommended that women delay routine mammograms until the age of 50. That was controversial, and "The task force's recommendation goes against two decades of widespread use of the PSA test, a $35 blood test," Park reports.

"The recommendation is not just counter to what the lay public has been taught about cancer prevention but what physicians have been taught as well," said Dr. Michael LeFevre, co-vice chair of the USPSTF and a professor of family and community medicine at University of Missouri. "We've been told for decades to be afraid of cancer and that the only hope is early detection and treatment. So it's hard for physicians and patients alike to accept that not all cancers need to be detected or need to be treated and that there are harms associated with screening, not just benefits."

Through PSA testing, physicians "were finding the cancer earlier, so the time from diagnosis to death was longer, but the patient wasn't actually living longer," explained Dr. Otis Brawley, chief medical officer of the American Cancer Society.

But there isn't a better test to replace the PSA, and Ian Thompson, chairman of urology at the University of Texas Health Science Center, said to reject it completely is unwise. He said U.S. death rates from prostate cancer dropped between 30 and 50 percent since the screening became commonplace in the early 1990s, though those numbers could also have been influenced by more effective treatments. Thompson said he didn't want to go back to the "bad old days" when doctors only found prostate cancer when it was already unable to be cured, reports Liz Szabo for USA Today.  (Read more)

Study finds new prostate-cancer test is better than current one

Researchers at the University of California at Los Angeles say they have developed a new test for prostate cancer that is "more sensitive and more specific" than the usual test for prostate-specific antigen, the UCLA Health System says in a news release on a new, peer-reviewed study.

"The conventional PSA test for prostate cancer has been used for nearly 30 years and is not specific enough in delineating between malignancies and non-malignant diseases of the prostate, such as benign prostatic hyperplasia (BPH), an enlarging of the prostate common in aging men that increases PSA levels," the release said, citing urology professor Gang Zeng, senior author of the study, published in the May issue of the Journal of Translational Medicine.

The new test "measures levels of PSA as well as six specific antibodies found in the blood of men with the disease," the release says. "The test, called the A+PSA assay, also reduced the rate of false-positives, tests that indicate the presence of cancer when no disease is actually present." For more from Newswise, click here.