Understanding Prostate Cancer
- Ray Finnerty, 50, was 47 when he was diagnosed with prostate cancer. His only symptom of the disease was a stiffness in his legs that, thankfully, brought him to the doctor.
- Prostate cancer, the most common form of cancer in men, can sometimes be misdiagnosed based on results from a PSA test. Still, our experts maintain that the PSA tests are helpful, and you should talk with your doctor about your own risks for the cancer and screening options.
- Symptoms of the disease are inconsistent and hard to pinpoint but may include changes in urinary function like urinating more or less often or waking up at night to go more than usual.
When Finnerty, then 47, first went to his doctor, he was struggling with leg stiffness. But a PSA test showed his PSA levels were elevated.
Read MoreAnd thank goodness he did because that visit with the specialist led to a referral to the rapid prostate clinic where he received his aggressive prostate cancer diagnosis.
“I had no other symptoms,” he said. “No frequency around going to the toilet. And I had no family history of prostate cancer.”
After undergoing a CT scan, MRI and bone scan, Finnerty’s team decided a radical prostatectomy an operation where the surgeon removes the entire prostate gland plus some of the tissue around it, including the seminal vesicles plus the removal of some nearby lymph nodes was the best option for his treatment.
"I spent six nights in the hospital. I came home with a catheter," the father of three teens said.
He has his PSA levels tested every six months, but he’s since recovered and returned to his work as a train driver. He’s even inspired some of his colleagues to get their PSA levels tested.
“The biggest shock was not having any symptoms and then for the cancer to be so aggressive," he said. "I've a completely different outlook on life now. Any time I get a pain or ache, I'm wondering."
Understanding Prostate Cancer
Before we talk more about prostate cancer screening, let's get a better understanding of the disease itself. Prostate cancer is the most common cancer in American men except for skin cancers. About one in eight men will be diagnosed with prostate cancer during his lifetime. The disease begins in the walnut-shaped prostate gland located between the rectum and bladder. This gland produces the fluid that nourishes sperm.
RELATED: Prostate Cancer: Overview
Symptoms of the disease are inconsistent and hard to pinpoint.
"Prostate cancer is a very odd disease in that it doesn't have a particular symptom," Dr. Edwin Posadas, director of translational oncology and the medical director of the Urologic Oncology Program at Cedars-Sinai, explained.
But changes in urinary function like urinating more or less often or waking up at night to go more than usual could be a sign of the disease. However, it's important to note that these potential symptoms could also could be caused by a urinary tract infection or even an enlargement of the prostate gland (which is not cancer).
There's No One Definitive Symptom for Prostate Cancer, But There Are Clues
Doctors that have spoken with SurvivorNet shared a hopeful outlook when considering a prostate cancer diagnosis because there are many treatment options, and there's been significant treatment progress over the past decade. Surgical and radiation options, for example, have made improvements in reducing side effects of treatment while still providing excellent cure rates. Even for men with an advanced-stage diagnosis, many new options exist to treat prostate cancer and help them maintain an excellent quality of life.
Prostate Cancer Screening
In the United States, many prostate cancer cases are caught with screening examinations. Screening guidelines depend on your risk for the disease. Age, race/ethnicity, geography, family history and gene changes are the main risk factors for prostate cancer. You should talk with your doctor regardless, but here are some things to consider when gauging your risk for the disease:
- Men younger than 40 are less likely to get prostate cancer, but age-related risk quickly rises after age 50. Approximately six of ten cases of prostate cancer are found in men older than 65.
- Prostate cancer develops more often in African-American men and in Caribbean men of African ancestry than in men of other races, and these men tend to develop the disease at a younger age.
- Prostate cancer is most common in North America, northwestern Europe, Australia and on Caribbean islands. It is less common in Asia, Africa, Central America and South America. The reasons for this risk factor are unclear, but more intensive screening and lifestyle differences like diet might be contributing factors.
- Most prostate cancers occur in men without a family history of the disease, but it's still important to look at your family history because prostate cancer does seem to run in some families. Having a father or brother with prostate cancer, for instance, more than doubles a man's risk of developing the disease with a higher risk for men with a brother with prostate cancer than those with a father who have it. The risk is also especially high if a man has several affected relatives that developed the cancer at a younger age.
- Inherited gene changes, or mutations, like that of the BRCA1 or BRCA2 genes can also elevate risk, but this probably accounts for a small percentage of overall cases.
It's not clear if the benefits of prostate cancer screening outweigh the risks for most men. Nevertheless, screening can be life-saving, and it's important to at least discuss the pros and cons of screening and your risk factors for the disease with your doctor.
Prostate cancer screening methods look for possible signs of the disease, but they can't determine for sure if you have cancer. The only way to know for sure if the patient has prostate cancer is with a prostate biopsy a procedure in which small samples of the prostate are removed and examined under a microscope. But generally speaking, screening for prostate cancer involves a PSA (prostate-specific antigen) test and a digital rectal exam to feel the prostate gland.
When Should I Get Tested for Prostate Cancer?
"It's slightly uncomfortable but painless, and takes less than 30 seconds," Dr. Posadas said of these methods. "The amount of information that is gained from that is tremendous, and it can be a life-and-death type decision that is made."
But it's important to note that the PSA test is not perfect. The prostate-specific antigen is a protein secreted by the prostate gland. Men have a small amount of PSA in their blood all the time, but large amounts can be a sign of cancer because when cancer cells grow, PSA spills into the blood.
An elevated PSA test, however, does not always mean you have prostate cancer. It can simply reflect that your prostate is enlarged which is common or it could signal an infection or inflammation. Because of this, the PSA test is controversial since high levels may lead to over-treatment in men who are more likely to die from something else. Regardless, our experts maintain that the PSA tests are helpful, and you should talk with your doctor about your own risks for the cancer and screening options.
Learn more about SurvivorNet's rigorous medical review process.