Have you ever experienced unexplained changes in your urinary habits or noticed a drop in sexual function? These can be early warning signs of prostate issues, including prostate cancer, which affects a significant number of men globally. As we observe Prostate Cancer Awareness Month, it’s an ideal time to focus on the importance of early screening and proactive health management. We spoke to our expert Dr Jaspreet S Sandhu, MD, Urologic Surgeon, Memorial Sloan Kettering Cancer Center, New York, US, who explained when and why you should start screening, how often to get tested, and the range of treatment options available.
According to the Indian Journal of Urology, prostate cancer is the second most common cancer and the sixth leading cause of cancer-related deaths in men worldwide.
As the global population ages, projections indicate that by 2030, 1.7 million new cases of prostate cancer and nearly 500,000 deaths will occur annually, as stated in a 2014 study.
"In India, where the disease ranks among the top 10 most prevalent cancers, the survival rate over five years is 64%, with men over 65 being the most affected demographic," added Dr Sandhu.
"The disease begins in the prostate gland, a small, walnut-shaped organ responsible for producing seminal fluid that nourishes sperm. Located below the bladder and adjacent to the rectum and urethra, the prostate’s position means that diseases affecting it, including cancer, can impact the urinary system," said Dr Sandhu. Moreover, the proximity of nerves and blood vessels essential for erectile function means that prostate cancer or its treatments, such as radiation, can also affect sexual health.
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When to Start Prostate Cancer Screening?
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“The right time to begin screening for prostate cancer depends on several factors, with age being a primary consideration. For men at average risk, most guidelines recommend beginning screening at age 50,” said Dr Sandhu.
However, if you have risk factors, such as a family history of prostate cancer, particularly if a close relative was diagnosed before age 60 or is of African descent, you may need to begin screening earlier, around age 45.
“Men with genetic mutations like BRCA1, BRCA2, HOXB13, or ATM should also consider early screening, as should those with a history of obesity or other related conditions. It’s also important to consider symptoms that might indicate the need for screening, such as blood in the urine or semen, significant weight loss, erectile dysfunction, difficulty urinating, and bone pain,” added Dr Sandhu.
Why Is Screening Critical?
“Screening tests, such as the Prostate-Specific Antigen (PSA) test, can identify prostate cancer before symptoms appear, which is often when the disease is most treatable. Early detection allows for a wider range of treatment options, potentially reducing the severity of the disease and improving overall outcomes,” added Dr Sandhu.
Another common screening method is the Digital Rectal Exam (DRE). During this procedure, a doctor inserts a gloved finger into the rectum to feel the prostate for swelling, inflammation, or abnormalities, such as hardness or nodules. By starting screening at the recommended age or earlier based on individual risk factors, you can take proactive steps to protect your health and address any potential issues before they become serious.
Also Read: Did You Know There Are Different Types Of Prostate Cancer? Know Which Is The Most Common One
How Often Should You Get Tested?
“The frequency of prostate cancer screening varies based on individual risk factors and initial test results. For average-risk men, screening is typically recommended every two to four years, starting at age 50,” said Dr Sandhu.
However, if you have a higher risk, such as a family history of prostate cancer or elevated PSA levels, your doctor may recommend more frequent testing. Monitoring PSA levels or abnormal findings through regular screenings can help detect changes early and guide your treatment plan.
Exploring All Treatment Pathways
Once prostate cancer is detected, treatment options vary based on the stage and specifics of the disease. Common treatments include:
- Radiation Therapy: High-energy beams target and destroy cancer cells, either externally or internally via radioactive seeds.
- Surgery: The removal of the prostate gland, sometimes including surrounding tissues, to eliminate cancer.
- Chemotherapy: Drugs are administered orally or through IV to kill cancer cells throughout the body.
- Immunotherapy: Enhances the body’s natural defences to fight cancer by either modifying cells or boosting the immune system’s response, particularly useful for advanced cancer.
- Hormone Therapy: Reduces testosterone levels, which prostate cancer cells rely on for growth, either through medication or surgical removal of the testicles.
- Focal Therapy: Cancer can focally be targeted with local modalities (eg. HIFU or cryosurgery) and then followed up with active surveillance.
- Active Surveillance: This is technically not a treatment, but if prostate cancer is low-risk, it can be followed with interval PSA and/or MRI testing to make sure there is no progression. If it progresses, then other treatments, such as surgery or radiation therapy can be considered.
Bottomline
Dr Sandhu concluded, “The decision of when to start screening and how often to get tested should be based on individual risk factors and made in consultation with a healthcare provider. By catching prostate cancer early, men have a better chance of successful treatment and long-term survival.”
[Disclaimer: This article contains information provided by an expert and is for informational purposes only. Hence, we advise you to consult your own professional if you are dealing with any health issues to avoid complications.]