Tech & testing make strides against prostate cancer

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Health

The risk of prostate cancer weighs heavy on the minds of most men, but technological advances are making it easier to detect and treat every day.

As men get older, changes occur in the prostate – the reproductive gland responsible for making semen – that may lead to cancer when cells don’t know how to stop growing, says Dr. Ryan Hedgepeth, a urologist for OhioHealth.

“We see the growth of a prostate by normal means, and we can’t control it by methods of shrinking the prostate, so this is probably a disease in most men that takes decades to develop. It’s slow-growing in most men, but occasionally, we think it can develop when it’s a more aggressive style and grows faster,” Hedgepeth says. “It’s a disease that grows over time, as most cancers do, and it’s a disease that we most typically see in men over the age of 50.”

There are no symptoms for early treatable prostate cancer, but occasionally, doctors will see men who have difficulty urinating in their 40s, 50s and 60s, Hedgepeth says. Still, he stresses the importance of testing, especially for black men and men with family histories of prostate cancer, who should start screenings at age 40.

If a man’s father or brother has had prostate cancer, that man’s risk is doubled. If both his father and brother have had it, the risk is five times that of a man with no family history.

“Genes have the biggest impact on whether a man develops prostate cancer or not,” Hedgepeth says.

Testing requires a blood test known as a prostate-specific antigen, or PSA, test. Once an abnormal blood test is found, the subject should have a prostate biopsy, in which cells are collected and examined through a microscope to determine whether they are cancerous.

“If you don’t have risks in your family or you’re not African-American, we typically think 50 is a good year to start getting screened,” he says. “There’s been some controversy about the PSA testing recommendations over the last 10 years, and along with the screening recommendations, I think we’re starting to see a convergence that PSA testing, when used responsibly, is a very good screening mechanism that helps prevent death long-term from prostate cancer.”

There is good news, Hedgepeth says: Technology has advanced to the point where prostate MRIs are being performed on men who have had negative biopsies, but still have rising PSA levels.

“In those men, we can sometimes see lesions that are suspicious on the MRIs … and OhioHealth has been very supportive developing innovative ways to diagnose and treat prostate cancer,” he says.

Robotic surgery is another option that has been expanding of late in the world of prostate cancer treatment, Hedgepeth says, though he notes that not every patient needs surgery. Radiation therapy has also made significant advances, as have other areas of treatment.

“We now realize that there’s a large group of prostate cancer patients who don’t need to be treated with either of those things. There is this group of patients who will have prostate cancer for 20 or 30 years and perhaps never die of it, and we’re really moving our processes of thinking about prostate cancer and identifying who those patients are that don’t need to be treated and, also, who are the ones who need robotic surgery or radiation therapy,” he says. “I think the real biggest bang for the buck patients are going to see is the identification of who and who shouldn’t get treated for prostate cancer.”

Even after having been treated for prostate cancer, men should make lifestyle changes to ensure their future health, Hedgepeth says.

“Exercise actually improves the overall survival for all cancer patients regardless of the cardiovascular benefit,” he says. “I encourage all of my patients – after surgery, after radiation or even if we’re following their cancer – to exercise regularly. I encourage four days a week, 30 minutes of cardiovascular activity.”

The best treatment option for prostate cancer is something that Hedgepeth says he discusses openly with his patients.

“I try to take the emotion out of it, even though it’s an emotional process for patients, and affirm what we’re doing with the science. In doing so, the emotion I want to change them to is hope, and it’s a fact that the science of prostate cancer continues to evolve and most patients will do very well as long as you do the right thing by that,” he says. “Ultimately, you want to have happy, healthy and well-adjusted patients, and I think what I do is I help facilitate those decisions to the right choice.”

Matthew Kent is a contributing writer. Feedback welcome at gbishop@cityscenemediagroup.com.

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