PROSTATE CANCER

Cancer is the word that has brought agonizing pain and terror to the last half of the twentieth century. To most people cancer means death. Many still think that a man with cancer has a death sentence. Not true. Increasingly in this last decade of the century it is proving not necessarily so. There are hundreds of different kinds and types of cancers, the medical experts tell us, and some can and are being cured. One of those types of cancer strikes men in their prostate. Cancer is described as being an uncontrolled growth of abnormal cells. Cancer cells can spread quickly throughout the body through the blood stream and the lymph system. Wherever they lite they create new tumors that begin replacing the normal tissue.
Some types don’t move at all, some are aggressive and attack different parts of the body quickly first. Cancer can develop in the lymphatic system, in bones, a man’s lungs, chest, throat, colon, stomach, even his brain. One of the areas cancer hits in a man is his prostate. When cancer strikes a man’s prostate it is usually what doctors call a primary cancer. This simply means the cancer begins, originates, in the prostate and has not been transported there from some other cancer in another part of the body.

WHAT CAUSES PROSTATE CANCER?

Scientists say there are hundreds of different kinds of cancer and they undoubtedly are caused by hundreds of different inciters. A few of the cancers have been researched enough so the medical people have the beginnings of the causes of them and can then go ahead and utilize some kind of anti-body to stop or kill the cancer. Massive research is going on for many forms of cancer, but less than one percent of that work is being done on prostate cancer. What this says is that there probably won’t be a miracle cure for prostate cancer within the lifetimes of most of us. That, like some of the preventive inoculation vaccines we have, will have to be applied to our children or our grandchildren. So who can develop prostate cancer? Unlike smoking and lung cancer, there isn’t even a hint of what might cause prostate cancer. Most researchers have ruled out any of the usual work and behavior activities such as alcohol, diet, work place, smoking, venereal diseases, too much sex or too little, or any other currently defined lifestyle.
There is one exception: men who work in nearly constant exhaust fumes from cars and those exposed to cadmium in the work place, are found to be at slightly higher risks of prostate cancer than the rest of us.
The one constant in prostate cancer and man seems to be age. As with the enlargement of the prostate, cancer seems to strike older men. Yes, some men die of prostate cancer in their forties, but most of the confrontations with the disease comes when men are over sixty. One researcher reports that the average age of men who are diagnosed as having cancer is seventy-two. Slightly over eighty percent of all prostate cancers reported come in men who are over the age of sixty-five.
Most doctors understand that by the age of eighty, nearly eighty percent of men have cancer of the prostate to some degree too. It may have been dormant for years, or it may just be starting and of a type that will grow slowly. Most of these men will never develop any symptoms of prostate cancer and will die of some cause not related to their prostate.
Most of our readers probably know someone who either has prostate cancer or has died of it. The American Cancer Society says that one out of eleven Americans will develop cancer of the prostate during his lifetime. Nearly 100,000 prostate cancer cases are reported by doctors each year. With men living longer now each year, there is expected to be an increasing number of prostate cancers. Men are simply living longer now and that’s when the disease develops. The American Cancer Society reports that nearly 28,000 men died of prostate cancer last year.

WHAT CAN THE AVERAGE MAN DO?

The problem is far from hopeless. They key to any cancer, and especially prostate cancer, is to catch the problem as early as possible. Some urologists suggest that all men over forty should have a digital rectal examination once a year.
Most of these examinations will be negative, which is good news to the man examined. We do dozens of examinations each year on people and expect negative results. Cholesterol testing is done routinely on people in their twenties and thirties, but the problem usually isn’t critical until much later in life. Chest X-rays are done routinely with usually a 99% negative result.
Testing for prostate cancer should be as routine for all men over forty. Yes, it’s a bit uncomfortable, but not painful. It takes about three minutes in a doctor’s office. Some urologists say the digital exam of the upper two lobes of the prostate will reveal ninety percent of prostate cancer. Other urologists think this is a bit high, but the exam should be made.
If such exams could catch 50% of starting prostate cancers in an early stage, most of those could be cured completely.
The big problem with prostate cancer is that it is a silent killer. It can show no symptoms at first. By the tune it starts hurting, the cancer usually has spread into other parts of the body and it’s often a matter of time until it kills the patient.

SCARE TACTICS?

If your reading this book does nothing more than makes you decide to have a yearly physical examination including a digital rectal exam of the prostate, that will be reward enough. You could be saving your life with a digital examination by discovering a cancer early enough to cure it.
Right now, about sixty-four percent of prostate cancers are discovered while they are small. Of these men, almost eighty-four percent are still alive five years after their surgery. Doctors compile statistics on cancer patients and most consider a man cured after a 15 year free period. The secret is catching it early so all of the cancerous tissue can be removed so it can’t spread or grow again. Ann Landers in her syndicated column has repeatedly pushed for greater awareness of testing to catch early cancer development. In one recent column she urged women to do the job this way. Whenever they go in for a mammogram, usually once a year, they should make an appointment for their husband to have his prostate checked by a digital exam or by the more expensive ultrasound probe. She urges women to do this so they won’t become premature widows. The lady has a good idea.
The American Cancer Society reports that currently seventy-one percent of all patients with cancer of the prostate live for five years or more after treatment. That’s for all cases whether diagnosed early or late. The later the diagnosis, the worse the chance for a cure.

HOW DOES YOUR DOCTOR KNOW IT’S CANCER?

More and more these days there is a push to try to catch prostate cancer in its earliest stages. This is a difficult job because very small cancers in the prostate traditionally have been from hard to impossible to detect by the traditional digital exam.
Now there are new tools to use to find these cancers. One of the best may be a simple blood test called the PSA. That stands for Prostate Specific Antigen. Prostate antigen is a protein found only in the prostate tissue. It has long been known that when the prostate is cancerous, the antigen level is elevated. The problem has been in finding how much this elevation may be made when the cancers are small and can’t be felt digitally.Now with the PSA there has been enough research to make some general pointings.
The tests showed that in the BPH men when the level of antigen had risen to 4 units, BPH was likely by a ratio of 4 to 1. But when the antigen level lifted to 10 or more units, the likelihood of cancer was more likely by a ratio of 33 to 1. Cooner also suggests the use of prostate ultrasonography as another diagnostic tool for screening patients who fall in the over 50 year category. This is done with a probe in the rectum and the use of ultrasound to reveal the tissue and mass in the prostate area.
Cooner concludes in his paper that we need to employ these two tools in a try to improve the ability to find curable cancers before they cause pain. He suggests that all men over 50 years should have a digital rectal elimination, then a PSA blood test, and a prostate ultrasound sonogram done as a baseline for future comparisons.
At this time PSA looks like a tool that the urologists need to make more use of. What if it only catches two or three percent of early cancer cases. Those men, cured of their cancer, are going to be wildly enthusiastic about the benefits of the test. As a parallel, how many positive readings do physical exams get these days from a routine chest X-ray? A dramatically low percentage.

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