Each day there are advancements in screening and treatment options for cancer patients across the globe. Since September is Prostate Cancer Awareness Month, we wanted to share a little bit of screening advice from our doctors, along with new advances in treatment options.
The first thing is to always be aware of what is going on with your body. If something does not feel right, get your doctor’s opinion.
“The prostate gland is a very small gland and if it does become enlarged with cancer, you can have symptoms such as abdominal discomfort, pelvic pressure, blood in the urine, and urinary hesitancy or urgency,” says Jordan Ciuro, MD. Ciuro is a professor of Medicine at the Medical College of Georgia.
While those are common symptoms, Ciuro has seen patients who have felt no symptoms at all, yet still have prostate cancer. She encourages men above 50 to get annually screened so that if the cancer does show up with no symptoms, they can catch it.
“If you’re a man at high risk of prostate cancer – you have a family history of prostate cancer, you’re African American, or you have family history of carrying the BRCA1 and BRCA2 breast cancer mutation – we recommend you start screening at age 40,” Martha Terris, MD, says. Terris is the Chairperson for the Department of Urology at the Medical College of Georgia at Augusta University.
Many men are hesitant to get screened due to fears and concerns about what will come if they end up testing positive, like a negative impact on their sexual functions. Remember, your doctor is there to provide you support and listen to your concerns. Let your doctor know if this fear is holding you back from getting screened as they most likely will have a solution that fits your needs.
When it comes to younger patients, that solution just might be active surveillance.
“In the last decade we’ve become smarter at choosing who we treat,” Terris says.
For young patients who have low-grade prostate cancer, with healthy bladder and sexual functions, active surveillance is a possible option. With active surveillance, a patient goes in for a PSA screening every 3-6 months to keep an eye on the cancer and the grade it is at. The lower the grade, the less aggressive the cancer is.
With this form of delayed ‘treatment’, a patient can put off dealing with the side effects of radiation or chemotherapy for a few years, which is important if the patient is young.
Another advancement in treatment is with hormone therapy. Patients undergo Androgen Deprivation Therapy, ADT, which lowers the amount of androgens, or male hormones, in the body. This is important as male hormones can cause prostate cancer to grow and become more aggressive. Recent data has shown the adrenal glands produce these hormones. New medications can now be given to patients to inhibit the creation of the androgens and to ‘starve’ out cancer, so the growth is slowed in multiple areas of the body, not just a single spot.
“We are finding that in most cases, single-agent androgen deprivation therapy is found to be inferior to intensifying therapy to double or triple therapy in the metastatic setting,” says Curio when discussing ADT. “We have many combination therapies available and are now looking at clinical trials evaluating targeted therapy in this patient population.”