With September being Prostate Cancer Awareness Month, it’s a great time to educate men on the prostate and how to be on the lookout for problems. Dr. Sean Doyle, one of 11 urologists at Mercy Clinic Urology in Joplin, has answers to the most important prostate questions.
What is the prostate and what does it do?
The prostate is a walnut-sized organ that sits right outside the bladder. It has several functions, but the main one is the secretion of fluid to help sperm survive the female reproductive tract.
I tell my patients to think about it as a complex piece of plumbing important for urination and fertility. Unfortunately, in about 1 in 7 men, cells in the prostate stop responding to our normal control systems. This results in uncontrolled cell growth, also known as cancer.
This loss of control varies between men, so the cancer can behave very differently among men. Some men will never be affected by cancer cells in their prostate even if they don’t receive treatment, whereas others will die of their disease despite aggressive therapies.
What are the symptoms of prostate cancer?
Most men who have early prostate cancer don’t have any symptoms. It is detected with an elevation in a protein in the blood called prostate-specific antigen (PSA) or through a prostate exam. Later symptoms can include a change in the frequency or strength of urination, blood in the urine or ejaculate, weight loss and pain.
With much debate about prostate cancer screening, what is your advice to men?
While there has been much discussion about when prostate screening is indicated, the American Urologic Association recommends discussing PSA screening with patients between the ages of 55 and 69 as these patients tend to benefit most from screening. Screening is not recommended in low-risk men ages 40 to 54 or over 70. However, risk factors like family history of prostate cancer and African-American race should be considered when deciding the age to start screening.
An important distinction should be made between a screening test and a diagnostic test. If there are symptoms suggesting there may be issues with the prostate gland, a PSA may be an important part in the diagnostic workup, regardless of age.
I’d also add that when it comes to screening, there are a couple of things I ask patients to consider. If prostate cancer is detected early, when the disease is confined to the organ, nearly 100 percent of patients will survive their cancer at five years and 98 percent at 10 years.
When the cancer has spread, however, the five-year survival rate is less than 30 percent. That’s a pretty strong incentive to identify cancer early. The PSA is the most widely available test for early detection.
What changes have you seen in the treatment of prostate cancer in the last 10 years?
One of the biggest changes is in the treatment of men with low-risk, early-stage prostate cancer. These are the patients for which we believe the risks of cancer treatment outweigh the benefits.
In other words, you are more likely to suffer if your cancer is treated than if you do nothing for now. We closely monitor the cancer in these patients. This is called “active surveillance” and should be discussed with every patient with low-risk prostate cancer.
There have been incredible advances in the treatment of early and late-stage prostate cancer. Robotic-assisted surgery, which is available at Mercy Clinic Urology, to remove the prostate gland offers many benefits, including less blood loss, less pain and faster recovery. This surgery has all but replaced open surgery for prostatectomy.
Many medications to treat late-stage prostate cancer have been approved in the last 10 years. Eventually, we hope to turn prostate cancer into a disease that men live with and manage for years instead of it being a cause of death.
Any suggestions to help men maintain good prostate health?
When asked that question, I tend to refocus patients from prostate health to overall health. I tell people that what is good for their heart also is good for their prostate.
Do what you know you should be doing. Get to your ideal body weight, eat right, exercise, don’t smoke, and please stay away from “prostate supplements.” Neither their ingredients nor their claims have been fully evaluated.
Dr. Sean Doyle is a board-certified urologist with extensive training in the laparoscopic and robotic treatment of urologic cancers including prostate, bladder, kidney, adrenal and testis. You can reach his office by calling Mercy Clinic Urology – Joplin at 417-556-3828.