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ASK THE EXPERTS

HOWARD ADLER, MD.

Patient Question

Learn Important Facts About Prostate Cancer


HOWARD ADLER, MD.
HOWARD ADLER, MD.

Director, Prostate Care Program

Expert Answer

Howard L. Adler, MD, Director of the Prostate Care Program, shares what men need to know now-especially about prostate cancer.

What do men need to know now about prostate cancer?
According to the American Cancer Society one in six men will develop prostate cancer in his lifetime, and an estimated more than 217,730 cases will be diagnosed in 2010 alone. Currently, prostate cancer ranks as the number one solid organ cancer in the country. The good news is that prostate cancer has a very high survival rate-upwards of 85 percent to 90 percent-so educating yourself can make a difference.

What is prostate cancer and what are the symptoms?
The prostate is a walnut-sized gland located below the bladder and in front of the rectum in men. Nearly all forms of prostate cancer start with small changes in the size and shape of the prostate gland cells. These cells can grow uncontrollably, creating tumors. In most cases, these tumors grow very slowly; however, in a small percentage of cases, they can be more aggressive.
Unfortunately, prostate cancer in the early, slow-growing stages is almost symptom-free. Bone pain or blood in the urine may indicate an advanced stage of prostate cancer. But the majority of men have no signs or symptoms. That's why it is so important to be screened regularly.

What do prostate screenings entail?
There are two components. One is the PSA blood test, which measures the level of prostate-specific antigens in the blood. Elevated levels may indicate the presence of cancer. The second component is the digital exam performed by a urologist. While this is the test that many men get apprehensive about, for the majority it is a quick and painless procedure, lasting just a few seconds. During this exam, the urologist checks for irregularities, asymmetry, and hard areas in the prostate. It is important to do both exams because it is possible for a person to have low PSA levels yet still have prostate cancer. Combined, the screenings are highly effective in early detection- key because when caught early, prostate cancer is highly treatable.

Who should get screened-and when?
The American Urological Association recently changed its guidelines to recommend that all men age 40 and over have annual screenings.

What are the risk factors for prostate cancer? They include:

  • Race-African Americans have higher rates than the rest of the population.
  • Age-Risk increases with age.
  • Family history-If your father, brother or grandfather had prostate cancer, your risk may be higher.
  • Diet-The high-fat, high calorie Western diet is a factor.
  • Agent Orange exposure-Past expose to this chemical brings elevated risk.
  • Viruses and infections-Researchers believe there may be a link between certain illnesses and prostate cancer.

 

What are the treatment options?
Perhaps the most important thing a man can do upon diagnosis is to find a urologist who he trusts. A good urologist is not only up-to-date on the available options, but also can help a patient choose the most appropriate course for his individual situation, taking into account his age, general health, and the stage of the cancer. For example, one patient may not need immediate intervention; it may be smarter to take what doctors call a "watchful waiting" approach. Another may benefit from a clinical trial-something that a urologist can connect him with. Stony Brook University Medical Center's Department of Urology, which has (for the second time) ranked among the top 50 in the country according to U.S. News and World Report, offers the full range of treatment options, including surgical removal of the prostate (prostatectomy) through traditional, laparoscopic and robotic procedures; radiation, including external beam and seed implant; hormonal therapies and medication; cryosurgery, or freezing of the prostate; and ongoing clinical trials.

What distinguishes Stony Brook's approach?
In addition to access to state-of-the-art technology and procedures, Stony Brook offers a multidisciplinary approach. At monthly genitourinary tumor board meetings, newly diagnosed cases are discussed by experts from the urology, medical oncology, radiation oncology, pathology, and radiology departments. Members of the prostate care team-physicians, physician assistants, urology nurses, nurse practitioners, operating rooms staff, and support staff-have specialty training and have worked together for many years. They are also connected with other resources at the hospital to ensure that patients receive the most comprehensive care possible.

If you are a man age 40 or over, be proactive about your health. For information about screening for prostate cancer or to make an appointment with a Stony Brook urologist, call (631) 444-4000.


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