Prostate Cancer: What Men Need to Know

September is Prostate Cancer Awareness Month, a good reminder to spread the word about this cancer and what a diagnosis entails. While no one wants to get a cancer diagnosis of any kind, prostate cancer is highly survivable if detected early.

Assistant Professor in the Department of Urology at University of Wisconsin in Madison, Dr. Christopher Manakas offers important information about prostate cancer including screening recommendations and treatment options.

Understanding Cancer vs. BPH

The prostate is a reproductive organ. Its function is to make semen. Starting at about age 30, the prostate starts to grow in a non-cancerous way and create enlargement that interferes with urination. For example, having increased urgency and frequency or difficulty starting the urine stream.

However, an enlarged prostate, also known as benign prostatic hyperplasia (BPH), does not necessarily indicate prostate cancer. In fact, many times it does not.

Why PSA Screening Is Important

One common misconception, per Dr. Manakas, is that men will “feel” prostate cancer. That is not the case, which is why screening is so important. A very specific blood test—one that’s not on the standard panel of labs—is able to pick up on increased PSA (prostate specific antigen) levels.

“A big prostate does not come from prostate cancer. Every now and then it can cause symptoms, but that is in an extreme minority of patients, less than two percent of total patients diagnosed with prostate cancer. So, we want to try to catch it early. And the only way to do that is with the PSA, because if you wait until you can feel it, often you’ve waited too long,” cautions Dr. Manakas.

PSA screening recommendations really depend on one’s personal and family history. But the general guidelines for a man of average risk are to begin screening at age 50. If there is a family history or genetic predisposition, the starting age could be as young as 40. If levels are out of the normal range, the next step is to visit with a urologist to determine next steps—such as MRI and possible biopsy.

Treatment Options for Prostate Cancer

Treatment for prostate cancer can take different forms. If the cancer is determined to be slow growing, many men opt to take a “careful watch” approach. Meaning, they undergo regular PSA checks to ensure levels aren’t spiking. Dr. Manakas notes that the side effects of treatment such as surgery or radiation can outweigh the benefits such treatment would provide men.

“We know that treatment often does more harm than good. Now, of course, all the details matter. We always take into account the patient preference and concerns about living with the diagnosis of the cancer. We take it very seriously and weigh all of the different factors,” he assures.

If the cancer is more aggressive or has advanced to later stages, it’s important to consider all of the patient’s options. Fortunately, today’s specialists and advanced technologies combined provide a hopeful path for men who may be in this scenario.

“There are a lot of treatment options available,” adds Dr. Manakas. “And, we have a multidisciplinary team of cancer specialists at the UW Carbone Cancer Center who partner with Fort HealthCare at the Johnson Creek Cancer Center, where there’s a state-of-the-art radiation treatment facility, cancer doctors, both for the medical version of cancer treatments where chemotherapy might be necessary, as well as radiation oncologists.”