Prostate cancer is the most common cancer afflicting American men, and yet early detection can cause more harm than good.
By Daniel Duane
Doctors have long recognized problems in how we diagnose prostate cancer, but those concerns turned urgent this October when researchers at the University of California–San Francisco and the University of Texas published a new analysis of large-population studies — one from the U.S., one from Europe — evaluating the effectiveness of widespread prostate-cancer screening. As PSA blood tests and rubber-gloved rectal probes have become routine indignities of middle age, there have been far more diagnoses but, as the U.S. study revealed, no meaningful reduction in deaths. This means that thousands are subjecting themselves to treatments that often cause impotence and loss of bladder control — without improving their chance of survival.
The prostate, a walnut-shape gland flush against the pelvis and encircling the urethra, produces part of your seminal fluid, the milky stuff that transports and nourishes your sperm. Since the advent of routine screening in 1986, about one in six American men have been diagnosed with cancer of this reproductive tissue. And it can be devastating. “Prostate cancer is a slow, painful death,” says Dr. Matthew Cooperberg, professor of urology at UCSF Medical School. “It causes fractures as it eats away at the bones, you can’t pee, there’s bleeding in the urine that can clot off the bladder.”
However, a large number of prostate cancers grow so slowly that the most likely cause of death for its sufferers is heart disease, simply because heart disease is the number one cause of death for men in general.
So where does that leave us? Get the screens? Skip ’em and wait for better screens and diagnostic tools? Here is what a few leading specialists recommend:
Get the PSA test, but primarily to establish a baseline. “What I tell people is, get screened, but don’t assume that a diagnosis will lead to treatment,” says Dr. Peter Carroll, chairman of the UCSF department of urology.
If a biopsy does turn up cancer, don’t seek treatment until you’ve employed a tumor-risk analysis tool like the UCSF-CAPRA score.
In the likely event that a tumor looks to be slow-growing, Carroll and others suggest delaying treatment in favor of “active surveillance,” involving a PSA blood test every three to four months, a prostate ultrasound every six to nine months, and an annual prostate biopsy.
Stay cool. Risk-analysis charts recently published in Know Your Chances: Understanding Health Statistics, written by three professors from Dartmouth Medical School, suggest that any 40-year-old’s chances of dying from prostate cancer in the next decade are less than one in 1,000.
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This article originally appeared in the December 2009/January 2010 issue of Men’s Journal.
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January 26th, 2010 at 10:50 am
My grandfather died of prostate cancer. I dont exactly know what causes it but studies show that constant exposure to STD poses a high risk in getting prostate cancer plus a diet high in fat or cholesterol adds to the risk as well.
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April 22nd, 2010 at 8:27 am
@April, that is really sad to hear. Prostate cancer can leave you feeling really helpless and depressed. I had a friend who just gave up on everything in life after finding out that he had it.
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May 22nd, 2010 at 7:42 am
I heard that having sex more often can help make sure you stay clear of prostate cancer. I wonder if this is true? or just some modern day wifes tale.
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Tomas Reply:
September 21st, 2010 at 9:11 am
I doubt it is the wives that would come up with that one… More like a husbands tale to tell their wives!
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September 13th, 2010 at 1:20 pm
some people taking the advantages of protest. They just stay behind the scene and perform their motives. really Gov should take care of this.
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February 5th, 2011 at 5:47 pm
A friend of mine just died of prostate and now I’m really scared of it, thanks you for this post, it’s really helpfull.
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June 23rd, 2011 at 7:25 pm
Great info, my father beat prostate cancer and I know how scary this can be.
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June 26th, 2011 at 1:36 pm
I fully understand how serious this can be, my dad was diagnosed with Prostate cancer and while he beat it, it was a long road.
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June 26th, 2011 at 2:35 pm
As a guy this really is a scary thing and alltoo common in this day and age. It seems every guy has some issue with their prostate when they reach a certain age. Keep up the good work on educating us all.
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July 6th, 2011 at 12:22 am
This is consciousness raising at its best. Establish baseline PSA. Excellent
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August 16th, 2011 at 6:52 pm
This is a tough issue. My husband never had any problems with his prostate and then a routine test shows a PSA of 26 and the biopsy results are not good. The doctor says there is only a 6% chance of beating it. Maybe my husband is that one in a thousand but when it happens to you it is 100%. Get screened, keep up on it, know your numbers and don’t brush it off as some simple thing you are more likely to die with than from. So far things are okay for us but the treatment is brutal, it just is better than being dead. We aren’t even done raising our children. We won’t know for some time how this will all turn out for us. It is scary!
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January 28th, 2012 at 9:44 am
I stumbled upon this office chair called The Carmichael Throne. This is the #1 most ingenious ideas I have ever seen, Or felt. The unique channel down the center of the chair relieves stress from sitting all day and from overexposure and negative tailbone pressure. It also greatly reduces pressure to the prostate when sitting. Before I found this, it always felt like i was sitting on a tennis ball but after sitting in this chair for a couple of weeks and purchasing my own now that feeling is gone. I highly recommend this chair for anyone that wants to sit comfortably.
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