Combating Prostate Cancer

Early detection, preventive measures make this a very treatable form of cancer

SUNDAY, Sept. 16, 2001 (HealthDayNews) -- If a man lives long enough, he's likely to get prostate cancer.

And if he doesn't discover the cancer early enough, he's likely to die.

That's the bad news. The good news is that prostate cancer is one of the easiest forms of cancer to detect and treat.

"If you have cancer, this is not a bad one to have," says Dr. Judd Moul, a clinical urologist at Walter Reed Army Medical Center in Bethesda, Md., and director of the Department of Defense Center for Prostate Disease Research.

"If prostate cancer is picked up early, it can be cured. Surgery and radiation are both very effective," Moul says.

"But once prostate cancer spreads, it is not curable. I don't like to see the ravages of advanced prostate cancer, because I have very few options to treat it," he adds.

The prostate is a walnut-size gland located just below a man's bladder. Its function is to produce fluids used in semen.

Prostate cancer is a leading cause of cancer death among U.S. men, second only to lung cancer. About 198,000 new cases are expected this year, and about 31,500 deaths.

Millions of men have early stage prostate cancer without ever realizing it. Autopsy results on men over the age of 80 reveal that 75 percent show evidence of prostate cancer.

With National Prostate Cancer Awareness Week beginning today, doctors are emphasizing the message of early detection and prevention.

But many men dread the prostate exam, which they should have annually beginning at age 50.

"They say, 'I feel fine -- I don't need someone sticking their finger up my rectum,' " says Dr. J. Brantley Thrasher, chairman of urology at the University of Kansas Medical Center.

But the digital rectal exam is still considered one of the best ways to detect prostate cancer.

Doctors recommend having a rectal exam along with a test called the PSA, which detects a substance in the blood called prostate-specific antigen. Elevated levels of PSA can be a sign of prostate cancer.

The medical community hopes to raise men's awareness of prostate cancer in much the same way that women have become aware of breast cancer over the last decade or so.

Reaching that goal may require overcoming some cultural and gender barriers.

"Men don't like talking about illness. They would rather deny it," says Thrasher. "They don't like touchy-feely support groups."

"Women have embraced the idea of screening for breast cancer. They're much more apt to talk about it, to get screened and to see their physician," he adds.

Physicians must do their part, experts say, by actively encouraging their male patients to get tested for prostate cancer starting at age 50.

African-American men, or men who have a history of prostate cancer in their family, should be tested even earlier -- beginning at age 40.

African-American men are about 1.5 times as likely to be diagnosed with prostate cancer as Caucasian men, and about twice as likely to die from the disease.

But a new study to be released this fall may show that the difference stems from poor access to medical care, not from any genetic tendencies.

The study, to be published in the journal Cancer, shows that the U.S. military has almost eliminated the disparity between white and black prostate-cancer rates.

"In the military, we have gotten aggressive about offering the PSA test," Moul says. "And everyone has equal access to health care."

It's unclear whether there are ways to specifically prevent prostate cancer. However, doctors say that a common-sense approach to diet and exercise can lower the risk of all cancers, including prostate.

"There is pretty good evidence that diets high in red meat and dairy are linked to increased risk of prostate cancer," says Dr. Durado Brooks, director of prostate cancer programs for the American Cancer Society.

"And there is some decent evidence that diets high in vegetables lead to some decrease in the risk," he adds.

Potential prostate-cancer fighters include grapefruit, tomatoes and watermelon.

Federally funded studies are under way to determine whether other substances can fight prostate cancer. Preliminary results show some promise for vitamin E and the mineral selenium.

In the meantime, stick to the basics and you can't go wrong.

"The way I prefer to couch it is that we have sufficient evidence that a diet low in red meat and dairy, high in vegetables and a regular active lifestyle promotes health in general," says Brooks.

"Those elements seem to decrease your risk of other types of cancer, and they may impact prostate cancer," he adds.

What to Do: Learn more about prostate cancer from the U.S. Centers for Disease Control and Prevention, or the National Cancer Institute.

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