Prostate Cancer: Know The Risks

September marks Prostate Cancer Awareness month. Though the month is coming to a close, it's never too late to be learning about the health issue.

The Prostate Cancer Foundation notes the complexity of the illness, with multiple subtypes of cancer existing--some exceedingly more aggressive than other non-life-threatening versions. The vast majority of prostate cancer occurs as an indolent, slow-growing form that can be treated. However, many aggressive types require more help.

Science World Report (SWR) spoke with Dr. Justin Mann, a resident in radiation oncology at Weill Cornell Medical College, New York, regarding the risks, prevention methods, treatments and potential future treatments.

"Older men and patients of African-American ethnicity are at greatest risk for prostate cancer," Mann told SWR. "Additionally, studies have shown that obesity and a high fat/low fiber diet can increase a patient's risk."

Though early stage prostate cancer typically has no symptoms, some more advanced forms may present with urinary problems, ranging from increased frequency, a weak stream or frequency at night. Additionally, blood in the urine, erectile dysfunction and bone pain may be nonspecific symptoms of the cancer, according to Mann.

Some controversy currently exists regarding the health issue, diagnosis and helping some men with prostate cancer live longer. The U.S. Preventive Services Task Force (USPSTF) currently recommends against prostate screening with Prostate Specific Antigen (PSA) test, but the American Cancer Society has more specific recommendations that entail a discussion with a health care provider regarding the risks and potential benefits of prostate cancer screening.

"Prostate cancer screening is very controversial, however the official recommendation of the American Cancer Society is that men have the opportunity to make an informed decision with their physician about whether to undergo screening," Mann said. "Many patients may opt out, whereas other patients who have had relatives suffer from prostate cancer may be more inclined to undergo screening."

Mann noted that all men over 50 and men younger than 50 at higher risk for prostate cancer are recommended to have this discussion regarding a screening, which involves a PSA test and a digital rectal exam.

Fortunately, for those who may be at higher risk for prostate cancer, there are numerous treatments available today, including surgery, radiation therapy, and brachytherapy (internal radiation). And for older patients who are too frail to benefit from treatment, there are surveillance options to monitor the disease, rather than treating at the present, which include active surveillance and watchful waiting. For patients who would like to avoid surgery, but opt for definitive treatment, outcomes with radiation therapy are also similar to surgery, according to Mann. 

And new treatments also lay on the horizon. Future treatments include proton therapy, which is a more advanced form of radiation therapy, available in only several centers nationwide, and clinical trials are currently ongoing to compare this treatment to conventional radiation therapy.

Additionally, there are numerous drugs in the pipeline for metastatic prostate cancer, including immunotherapy.

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