September 2008: National Prostate Cancer Awareness Month

Prostate cancer will strike one in every six men in their lifetime,[i] killing tens of thousands of husbands, fathers, brothers, and lovers each year in the United States[ii] alone. It is the second most common form of cancer in men after skin cancer and by far the most deadly. President George W. Bush declared this September to be National Prostrate Cancer Awareness Month "to underscore our commitment to fighting prostate cancer and to raise awareness about this highly treatable disease."[iii]

"The cause of prostate cancer remains unknown, but early detection can lead to better treatment and increase the chances of survival. It is important for men to talk to their physicians about risk factors, prevention, and preventive screenings," said President George W. Bush in his official Prostate Cancer Awareness Month Proclamation.[iv]

Regardless of what one thinks about the President's other policies-especially during a heated presidential election cycle-everyone should agree with his stance on defeating prostate cancer, and saving nearly 200,000 American men each year from this too frequently fatal disease.

"During National Prostate Cancer Awareness Month," President Bush continued, "we remember those who lost the battle against prostate cancer, and we pray for their families and friends. We also remember those living with prostate cancer, celebrate the lives of survivors, and thank all the medical professionals who aid in these victories. By continuing our fight against this disease, we will make our Nation a healthier and more hopeful place."

Screening for Prostate Cancer

National Prostate Cancer Awareness Month should encourage more men to talk with their physicians and get screened for prostate cancer, which can be detected even before symptoms appear. The hope is that early detection will lead to early treatment and lower mortality rates.

Doctors will use two basic tests for prostate cancer screening-a digital rectal exam or a blood test for prostate-specific antigens (PSA).[v] Both of these tests can suggest the presence of prostate cancer, but further testing will be required to determine how serious the disease may be.

Symptoms

There are a number of distinct prostate cancer symptoms, any of which should send a man to his doctor for prostate screening. These symptoms include:[vi]

· A need to urinate frequently, especially at night;

· Difficulty starting urination or holding back urine;

· Weak or interrupted flow of urine;

· Painful or burning urination;

· Difficulty in having an erection;

· Painful ejaculation;

· Blood in urine or semen; or

· Frequent pain or stiffness in the lower back, hips, or upper thighs.

Diagnosing Prostate Cancer

If a patient has prostate cancer symptoms or showed signs of potentially having prostate cancer in a screening, they will likely undergo a short battery of tests to confirm the presence of cancer or eliminate it as a cause of prostate swelling. These tests are likely to include a transrectal ultrasound, a transrectal biopsy, or a cystoscopy.[vii]

The transrectal ultrasound is a quick, "outpatient procedure that uses sound waves to create a video image of the prostate,"[viii] giving doctors a detailed picture of the gland's condition. During the procedure, "a small, lubricated probe placed into the rectum releases sound waves, which create echoes as they enter the prostate. Prostate tumors sometimes create echoes that are different from normal prostate tissue. The echoes that bounce back are sent to a computer that translates the pattern of echoes into a picture of the prostate. While the probe may be temporarily uncomfortable, [transrectal ultrasound] is essentially a painless procedure. Although [transrectal ultrasound] alone cannot detect every tumor, it has been shown to detect some tumors that cannot be felt by a [digital rectal exam]. In addition, [transrectal ultrasound] is used to estimate the size of the prostate gland, helping doctors get a better idea of PSA density."[ix]

A transrectal biospy is a "procedure in which a sample of tissue is removed from the prostate using a thin needle that is inserted through the rectum and into the prostate. Transrectal ultrasound is usually used to guide the needle. The sample is examined under a microscope to see if it contains cancer."[x]

Cystoscopy is an examination of the patients bladder and urethra (through which urine flows). The procedure uses a cystoscope,[xi] which is an ultra-thin form of an endoscope. The cystoscope can also be used to take a biopsy, allowing doctors to have samples of the bladder lining.

Prostate Cancer Treatment

Prostate cancer treatment varies greatly from patient to patient and most men will have a lot to say about their particular treatment regimen. In general, treatment options will either attack the cancer locally with radiation or surgery or the attack the "system" to stop the spread of the disease.[xii]

Properly treated, many men can survive prostate cancer, potentially making National Prostate Cancer Awareness Month more of a celebration.

[i] " Proclamation by the President of the United States of America: National Prostate Cancer Awareness Month, 2008," Market Watch, downloaded from http://www.marketwatch.com/news/story/proclamation-president-united-states-america/story.aspx?guid={B004ECDA-C3D2-4B23-8BD2-3909E7FFE6E5}&dist=hppr on August 29, 2008.

[ii] Kevin A. Nelson and John S. Witte, "Androgen Receptor CAG Repeats and Prostate Cancer", Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio, 2002; downloaded from http://www.cdc.gov/genomics/hugenet/reviews/Prostate.htm on August 29, 2008.

[iii] Market Watch.

[iv] Ibid.

[v] "What You Need To Know About Prostate Cancer," National Cancer Institute, U.S. National Institutes of Health, Bethesda, MD, 2008 downloaded from http://www.cancer.gov/cancertopics/wyntk/prostate/page5 on August 29, 2008.

[vi] "Prostate Cancer Symptoms," the Prostate Cancer Foundation, Santa Monica, Calif. downloaded from http://www.prostatecancerfoundation.org/site/c.itIWK2OSG/b.271349/k.87DD/Prostate_Cancer_Symptoms.htm on August 29, 2008.

[vii] Ibid.

[viii] "Transrectal Ultrasound," University of Pittsburgh Medical Center Cancer Center, Pittsburgh, Penn., downloaded from http://www.upmccancercenters.com/cancer/prostate/biopsyultrasound.html on August 29, 2008.

[ix] Ibid.

[x] National Cancer Institute, downloaded from http://www.cancer.gov/common/popUps/popDefinition.aspx?term=Transrectal+biopsy on August 29, 2008.

[xi] National Cancer Institute, downloaded from http://www.cancer.gov/common/popUps/popDefinition.aspx?term=Cystoscopy on August 29, 2008.

[xii] National Cancer Institute, downloaded from http://www.cancer.gov/cancertopics/wyntk/prostate/page9 on August 29, 2008.