Much like breast cancer, prostate cancer can be a silent killer.
“Prostate cancer is typically asymptomatic, which means a person can harbor cancer without having any new onset of symptoms,” said Dr. Clay Pendleton, a urologist in Steamboat Springs and a member of the medical staff at UCHealth Yampa Valley Medical Center.
Pendleton’s practice, which has clinics in Steamboat Springs and Summit County, diagnosed about 150 cases of prostate cancer last year. A third were significant or high-risk.
“We are discovering an extremely high rate of high-grade prostate cancer here in Routt and Summit counties,” Pendleton said. “Whether it’s due to improved screening or geographic differences remains to be seen.”
Below, Pendleton outlines what to know about prostate cancer and screenings.
What is the prostate?
The prostate is a small gland that sits near the bladder and is part of the male reproductive system.
“After the fertility stage, the prostate is a useless organ,” Pendleton said. “But it can become problematic by causing urinary problems or cancer.”
Studies show that men have a one in seven chance of developing prostate cancer, and a one in nine chance of being diagnosed with prostate cancer in their lifetime. That means a number of men die of undiagnosed prostate cancer.
“As we age, the risk of prostate cancer increases,” Pendleton said.
After lung cancer, prostate cancer is the most common cause of cancer deaths in American men. The American Cancer Society projects there will be 175,000 prostate cancer diagnoses in the U.S. and about 32,000 deaths from prostate cancer in 2019, which is a 6 to 7% increase from 2018.
What is a prostate screening?
A basic prostate cancer screening involves a digital rectal exam and a prostate-specific antigen (PSA) blood test, which looks for protein markers of prostate cancer in blood.
Additional tests such as the 4Kscore test and prostate health index check the blood for different types of PSA and help determine a patient’s risk for prostate cancer. There is also a new urinary test that checks for additional cancer markers.
If cancer is suspected and a biopsy is recommended, men can now take advantage of MRI prostate screenings.
“MRI fusion biopsies have increased the accuracy of detecting high grade prostate cancers by 40 percent compared to traditional standard office biopsies,” Pendleton said. “With the MRI technology, we miss fewer significant cancers and conduct fewer unnecessary biopsies.”
Who should get screened?
The American Urological Association recommends that men with no family history of prostate cancer are screened with a digital rectal exam and PSA test every one to two years between the ages of 55 and 70 to 75. African American men or men with a family history of the disease should begin screenings at age 40.
“We’re seeing a lot of patients with prostate cancer who had a family history of the disease,” Pendleton said. “The more significant the family history, the greater the risk of prostate cancer.”
What if cancer is found?
Treatment varies based on the stage of cancer.
“A lot of our low-grade prostate cancer patients will be placed under an active-surveillance protocol, where we do regular biopsies to be sure the cancer is not progressing,” Pendleton said. “For intermediate and high-grade cancers, we may surgically remove the prostate, treat it with radiation or freeze it.”
And remember, prostate cancer often affects otherwise healthy men.
“It’s different from something like heart disease,” Pendleton said. “Just because you don’t have any urinary issues or pain and you’re a healthy guy, it doesn’t mean you can’t have a high-grade prostate cancer.”
This article first appeared in the Steamboat Pilot & Today on Sept. 9, 2019.