Most people know that prostate cancer is a disease that affects only men, since the prostate gland is one part of the male genital/urinary system. But did you also know it’s the second leading cause of cancer death in men, just behind lung cancer?

Shocking statistics aside, prostate cancer is not a death sentence for many of the men who develop it. In fact, most men who are diagnosed with prostate cancer don’t die from the disease. And in even better news, the trend in death rates among men diagnosed with prostate cancer has been steadily declining since the mid-1990s, according to the American Cancer Society. We can thank better education, diagnosis and treatment options for that.

Speaking of diagnosis, one valuable tool that helps uncover prostate cancer is something called a PSA test. PSA stands for prostate-specific antigen. This is the protein produced by the prostate gland that can be a prostate cancer indicator depending on the levels or velocity of the protein in the bloodstream. However, a PSA test really isn’t a “cancer test.” There are some issues besides cancer that can result in an elevated PSA level in a man, from inflammation to infection, and this test alone isn’t a definitive prostate cancer detector. Instead, it can be a first step in further evaluating a potential problem.

If a physician is concerned with a man’s PSA levels and suspects prostate cancer, he or she would then move to more definitive diagnostic measures, including a biopsy of the prostate.

Research has currently not revealed a direct cause of prostate cancer, and a vast array of misinformation remains out there. For example, it was once suspected that having a vasectomy increased a man’s risk for developing prostate cancer. This topic has been researched heavily, and there is currently no reputable clinical evidence to prove it. Frequent ejaculation also was thought to cause the disease, but this has been debunked by science, especially now that some research is revealing a higher frequency is associated with a lower prostate cancer risk.

What is known is that there are vital factors that can increase prostate cancer risk. Beyond the age factor, these include:

• Genetics/family history (having a first-generation relative who has been diagnosed with the disease).

• Race and ethnicity (African-American men and men of African ancestry are at a higher risk than other races).

• Geographic location (prostate cancer is most common in North America).

When it comes to the treatment of prostate cancer, we again see varying schools of expert thought, and all have merit. Some medical experts believe treating a cancer that won’t likely result in death isn’t the best course of action. However, we can’t always know when a prostate cancer that starts out as “slow growing” may turn aggressive. These factors and plenty of others make the treatment decision a very personal one and require the thoughtful consult with loved ones and a trusted physician who can help make the treatment decision that’s right for you or the man you love. There really is no one-size-fits-all option here.

The process begins with having yearly PSA screening completed by your family doctor or urologist. There is a fair amount of controversy surrounding PSA screening. However, like I tell my patients, the seatbelt in car is not always perfect in protecting you in a car crash, but you still wear it. Like your seatbelt, the PSA is not a perfect test, but when done in a responsible fashion it is the best test we have to identify men at risk for prostate cancer and I recommend routine screening to be done in men beginning at age 55 in men at average risk.

Dr. Jay Carpenter is a practicing urologist at Red River Urology in Paris.

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