September is Prostate Cancer Awareness Month, a time to recognize the importance of early detection and regular checkups for the second most common type of cancer in men in the United States.
Naeem Rahman, MD, a urologist with Atlantic Health System, joins a Community Conversation to discuss the ways you can stay on top of your prostate health.
Why do we recognize Prostate Cancer Awareness Month?
Dr. Rahman says prostate cancer is one of the most common cancers found in men. Each year, over 200,000 men in the United States are diagnosed with the disease and the numbers are increasing. “It's more and more prevalent” said Dr. Rahman. “It's very common, and it's very treatable…if you screen for this earlier, you're going to probably have better outcomes.” He hopes that Prostate Cancer Awareness Month will help educate people on the importance of early screening and detection.
What tests are used for early detection of prostate cancer?
A prostate-specific antigen (PSA) test is the principle way doctors diagnose prostate cancer. A PSA is a blood test that is usually ordered by your primary care doctor. The test is very effective at detecting prostate cancer. Dr. Rahman says these high detection rates enable doctors to diagnose and treat any signs of cancer early.
What are the risk factors for prostate cancer?
Dr. Rahman explains that family history is an important risk factor, especially if a first degree relative (father or brother) developed the disease. There is also a link between prostate cancer and other types of cancers, including breast, pancreatic, and melanoma. Clusters of cancer in families increases your risk. Another factor is ethnicity. Dr. Rahman notes that men of African heritage have a higher risk for prostate cancer, and higher rate of mortality from prostate cancer. Age is also a factor; as you get older, your risk will increase. Men with any of these risk factors should be screened for early detection of the disease.
At what age should men get screened for prostate cancer?
Most people should get a screening at age 50. If you are African-American or if you have increased risk factors, including family history of cancer, you should get a screening in your forties. Dr. Rahman explains, “(There’s) more and more data that if you start in your forties, it's actually a very powerful tool. Getting a PSA in your forties helps to predict cancer much, much later in life. In fact…some data (shows) that, knowing your baseline PSA…(is) even more powerful than family history and ethnic background.” Dr. Rahman says that men should arrange their screening through their primary care physician or a urologist.
What happens if a screening reveals prostate cancer?
Dr. Rahman says that every patient is different, and their diagnoses and treatment plans will vary depending on a number of factors including age, family history and their PSA results. Some patients with aggressive forms of cancer may require treatments such as surgery, hormonal medications or chemotherapy, while others with less aggressive forms of cancer may only require increased observation. He emphasizes that prostate cancer impacts patients in different ways and that diagnosis and treatment is a nuanced process, tailored to the individual.
How has treatment for prostate cancer developed over time?
Dr. Rahman says one of the biggest developments in prostate cancer is the individualized approach to treatment. Forty years ago, most patients received the same treatment; over the past four decades, doctors have been able to refine options for each patient. In the past, the risk of incontinence, impotence and other side effects were high. These have been lessened with new surgical techniques and technologies. Dr. Rahman mentions the advent and implementation of robotic surgery tools such as CyberKnife that have helped to reduce blood loss and side effects as well as improve pain control and recovery time. In addition, he says there have been advances in hormone therapy and chemotherapy as well as innumerable new drugs that have come on the market. All of these advancements have improved survival rates and quality of life for patients.
Does Atlantic Health System use a multidisciplinary team to treat prostate cancer?
Atlantic Health System specialists work together to develop a treatment plan that’s designed for each individual patient. Dr. Rahman says that he works closely with a radiation oncologist and a nurse navigator in one office to chart the best course for patients newly diagnosed with prostate cancer. The collegiality that has developed with this medical team enables them to provide access to resources and multiple treatment options. The goal is to alleviate frustration, streamline care and determine what would best serve the needs of their patients.
Can men improve their prostate health through lifestyle choices?
Dr. Rahman acknowledges that many men who are otherwise healthy are sometimes diagnosed with prostate cancer. Some factors are outside of their control, including age, family history and ethnicity. But overall cancer rates are on the rise, and Dr. Rahman says that lifestyle choices about food, diet, exercise, stress and sleep may be variables that are contributing to the increase. He suggests being proactive about aspects of your health that are within your control. “Be mindful of your diet, of your blood pressure, of your diabetes risk. Make sure you're getting exercise, make sure you're socially engaged with your family, with your community. All these things are part of good health that I think need to be emphasized across the board.” He adds that a heart healthy diet is also a prostate friendly diet. Dr. Rahman recommends a diet low in saturated fats and animal protein and high in vegetables and plant based foods.
What is the first step towards prostate health?
Developing a relationship with your primary care doctor is the first step towards prostate health. Your doctor can order a PSA test, and address any symptoms or concerns you may have, including discomfort with urination, frequent urination or waking up at night to urinate. Dr. Rahman says these symptoms don’t necessarily indicate cancer, but early evaluation and detection are important for your health and wellness.
Be Proactive About Your Health
To stay safe and healthy, it's good to have a primary care provider who knows and understands your health history and wellness goals.