Facts that all men should have

Posted: Wednesday, Aug 27, 2008 - 10:24:26 pm PDT
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Sholeh Patrick

Sholeh Patrick

News of county treasurer Tom Malzahn's prostate cancer brought sadness and respect. Sadness for what he has to face, but respect for making public something so personal.

Tom hopes to encourage all men over 40 to get tested annually. Early detection means viable treatment options and great odds -- nearly 90 percent disease-free in five years. For the other 28,000 men a year, it's fatal.

Prostate cancer is the second leading cause of cancer death in men (one in five of those diagnosed) and the most commonly diagnosed cancer in the U.S. An estimated 2 million men now live with the disease. Age is a big factor. One in 10,000 under age 40 will be diagnosed; it soars to one in 39 for ages 40 to 59, and one in 14 for men over 60.

What it is: The prostate is the male sex gland, located below the bladder and near the urethra. A normal prostate is the size of a walnut, or about 20 cc. The average cancer-affected prostate is 40 cc. The prostate needs testosterone to function properly; suspected causes of prostate cancer include abnormal testosterone levels, family history, and a high-fat diet. The incidence of prostate cancer has risen steadily for decades, in part from improved diagnosis, but not fully explained.

Symptoms: In most cases there are no symptoms when diagnosed, although at advanced stages difficulty urinating may occur (also a symptom of many other conditions). That's why regular testing is vital. If the cancer has already spread to the bones, back and other pain may occur.

Diagnosis - PSA: Physical exams (DREs - digital rectal exams) can reveal nodules on the prostate. But a simple PSA blood test detects earlier. The prostate-specific antigen is a protein with a tumor marker unique to the prostate gland. A positive PSA test (typically over 4) may just mean an infection, so a biopsy is then taken by a urologist to confirm. The tissue cells are tested and receive a Gleason score (1-10; lower is better), a rating of the likelihood the tumor will spread.

Treatment: Over 70 percent of diagnosed prostate cancers are organ-specific; they haven't spread elsewhere and are thus operable. Other treatments include radiation, chemotherapy, and hormone therapy.

For more information see your M.D. and www.prostatecancerfoundation.org or www.cancer.gov.

Sholeh Patrick is a columnist for the Hagadone News Network. E-mail sholehjo@hotmail.com.