Men—Are You Talking with Your Doctor about the PSA Test?

One of the most important decisions a man can make is whether or not to have the PSA test as a screening tool for prostate cancer. Across the U.S., physician groups recommend that doctors talk to their male patients, especially those between ages 55 and 69, about the advantages and disadvantages of this test, but data for 2014 show that about 30% of men do not have this discussion with their doctors.1

One might wonder why the hype about having this “talk.” Isn’t the PSA test a potential lifesaver for men? Isn’t it a simple blood test? Is there any reason men should not have this test? The answer to all of these questions is a qualified “yes,” but let’s delve deeper.

Introduced in the late 1980s, the PSA test has been proclaimed as the best way to detect prostate cancer at an early stage when the rate of cure is relatively high. But most prostate cancers grow slowly, so while an elevated PSA level may indicate the presence of cancer, it does not tell us if the man will ever have symptoms of cancer or actual cancer. The PSA may overdiagnose nonaggressive prostate cancers and lead to unnecessary biopsies and treatments, or it may underdetect aggressive cancers that need treatment. And the PSA may produce a false positive due to temporary or non-cancerous conditions.

The value of the PSA test has become a controversial topic, and research continues on this important topic, often with contradictory conclusions. Overdiagnosis generally results in the man opting to go into high gear for the diagnosis and treatment of cancer, which may include an invasive transrectal ultrasound-guided (TRUS) biopsy, possibly followed by more surgery, radiation therapy, and/or chemotherapy. The consequences of such treatments may be significant and may include impotence, incontinence, and emotional upheaval.

For the man who opts for the PSA test and gets an elevated reading, technology now offers means other than the TRUS to determine if cancer is actually present. The newest technology for diagnosis is the multi-parametric MRI (mpMRI), a pain-free procedure that takes detailed images of the prostate to determine if a tumor is actually present. The mpMRI is highly regarded for diagnosing prostate cancer and predicting aggressive prostate cancers while eliminating the need for the uncomfortable TRUS. If any suspected lesion or lesions are confirmed, a targeted MR/US fusion biopsy can be performed to pinpoint actual lesions for biopsy. It is important that men discuss these options with their physicians before proceeding with the TRUS.

Sarasota Interventional Radiology, headed by Gerald E. Grubbs, MD, works closely with area urologists to coordinate and perform mpMRI and MR/US fusion biopsy. For more information, click here to go to our main website.

 

1 Harrison, Pam. (2017 April 25). Many Men Have No Discussion of Pros and Cons Before PSA Test. Retrieved from http://www.medscape.com/viewarticle/879065?nlid=114397_4503&src=wnl_dne_170426_mscpedit&uac=153271MX&impID=1335901&faf=1#vp_1

Enlarged Prostate Gland

By about age 50, about half of all men begin to experience enlarged prostate gland, medically known as benign prostatic hyperplasia or benign prostatic hypertrophy (BPH). This condition is often related to problems with urination because the enlarged prostate gland presses on or partially blocks the urethra, the tube that transports urine from the bladder out of the body.

The name, benign prostatic hyperplasia, means that the condition is not cancerous and does not lead to cancer. BPH also does not cause erection problems or male infertility. It is important to note, however, that although these conditions are not caused by BPH, they may occur simultaneously with BPH.

BPH is associated with some bothersome symptoms:

  • Urinary frequency, especially at night
  • Difficulty starting or completely stopping the urine stream
  • Producing a weak urine stream
  • Sensation of incomplete bladder emptying after urination

A more serious but less frequent problem caused by BPH is blockage of the bladder, which makes it very difficult or even impossible to urinate. When this occurs, urine may get backed up in the bladder (called acute urinary retention, or AUR) and cause bladder infection, bladder stones, gross hematuria and, in some cases, even kidney damage.

Explain your symptoms to your physician who will conduct an examination to assess the severity of your condition and determine if additional testing is recommended. Mild symptoms may require no immediate treatment but instead follow a plan for “watchful waiting/active surveillance.” More intense symptoms may be helped by medications, minimally invasive surgeries, traditional surgeries, or some combination of these treatments. Continue reading Enlarged Prostate Gland

CANCER PREVENTION–KNOW THE RISK FACTORS FOR CANCER

There are many risk factors for cancer, and some of these factors—such as age and family history—cannot be avoided. Also, some risk factors are environmental, such as chemicals in the air, water, and food as well as chemicals that are contained in the products we use and work with daily. Fortunately, researchers continue to study environmental and chemical causes of cancer and report their findings to help us avoid these carcinogenic elements as much as possible.

The Role of Inflammation

In recent years, it has been noted that chronic inflammation plays a big role in the prevalence of certain cancers. While acute inflammation is a normal response to injury that leads to the healing of tissue, the inflammatory stage generally ends when healing is complete. However, a condition called chronic inflammation may occur as a result of the body’s response to such factors as pathogens and foreign bodies, viral infections, high cortisol levels, and stress. Such exposures may result in DNA damage and increase the risk for some cancers.

Lifestyle Risk Factors

Many risk factors for cancer are directly related to how we choose to live and what we choose to consume. In a recently issued report on its survey about cancer prevention awareness, the American Institute for Cancer Research noted that fewer than half of the survey’s 1004 respondents were aware of lifestyle risk factors for this disease.1 In an effort to increase the awareness of lifestyle risk factors, we list in the table below some common lifestyle risk factors and associated cancers. We encourage those at risk to engage in lifestyle modification.

Continue reading CANCER PREVENTION–KNOW THE RISK FACTORS FOR CANCER