Doctors Urge Screenings

For Prostate Cancer

DANBURY –– Prostate cancer affects one in six American men. The disease is so common that at age 80, about 80 percent of men will have prostate cancer.

Since the disease rarely has symptoms, doctors at Danbury Hospital urge men to get a prostate screening. Edward Beck, MD, an urologist, and Noah Taylor, MD, a radiation oncologist, spoke at the recent Medical Town Meeting on “Prostate and Bladder Cancer: Beyond the Basics.”

 Medical Town Meetings are a series of health and wellness programs for the community, sponsored by Danbury Hospital. The hospital kicked off its 2003–2004 series of meetings in September.

Dr Beck explained that since prostate cancer usually forms on the outside of the prostate gland there are no symptoms. Symptoms of a problem can include a weak or interrupted urine stream or difficulty urinating, but as doctors point out, they can also signal benign disease.

Early detection screening consists of a PSA test and a digital rectal exam. The screening is recommended annually for men over 50, and after 40 for those at risk. Risk factors include a family history of the disease and being an African American.

As a community service, Danbury Hospital offered free prostate screenings on September 24–25 at the hospital.

While the PSA can detect disease, its use has also become controversial, according to Dr Beck. The PSA numbers can be misleading, and doctors often vary in their approach to who should be treated depending on the numbers. “The million-dollar question is who has it and who needs to be treated for it.”

For example, he said, an enlarged prostate not affected by disease can cause an elevated PSA. PSA numbers, he said, should be adjusted for age. What is a normal range for age 50, is no’t normal for age 70. He also reminded patients to keep in mind the importance of a changing PSA over time. “A change in PSA over time is very important.”

The doctors also pointed out that there are several treatment options for prostate cancer, and the choice is up to the patient. “There is no right or wrong treatment,” said Dr Taylor. It depends on what the patient is comfortable with.

The first option, according to Dr Taylor, is “watchful waiting.” If the type of cancer is slow growing, and an older man has less than a five-year life expectancy, the disease may not have to be treated.

Other treatments include androgen deprivation therapy, a treatment that slows the growth of cancer by cutting down on a hormone that causes it to grow.

Surgical removal of the prostate is another option, and today’s surgical advances make the procedure less complicated. Advances in radiation have also made that therapy better. Intensity modulated radiation therapy (IMRT) allows radiation to be targeted just to the prostate, leaving nearby cells unaffected.

Internal radiation, or brachytherapy, is also an option for some men, especially in the early stages or in cases of localized disease. It involves the implantation of radioactive seeds right into the prostate. Doctors say that cryosurgergy –– the use of liquid nitrogen –– is debatable.

The doctors also briefly reviewed the symptoms of bladder cancer, which affects men more often then women and is usually caused by smoking. Symptoms include blood in urine, frequency and urgency to urinate, and burning with urination.