Prostate Cancer: It’s a guy thing

By Michaela Gibson Morris/NEMS Daily Journal

Most guys would rather not go there.
But ignoring the risk of prostate cancer is a dicey plan of action.
Some 32,000 men still die from prostate cancer annually, which especially tragic considering prostate cancer in its early stages is considered one of the most treatable cancers.
“In the last couple of decades, there’s been a 30 percent decrease in death from prostate cancer,” said Tupelo Urologist Dr. Kris Whitehead.
Roughly one in 6 men will develop prostate cancer in his lifetime. And while family history of prostate cancer increase the risk, most men who develop prostate cancer have no specific risk factors other than being male and having birthdays.
The advent of annual screening with a blood test – prostate specific antigen, commonly known as the PSA – and a physical exam has changed the odds.
“Ninety-one percent of what’s diagnosed is localized disease,” Whitehead said.
Sims Reeves of Tupelo is a believer.
“Early detection is the key,” said Reeves, who is a 14-year prostate cancer survivor and a member of the Man-to-Man Support Group for prostate cancer survivors .

New guidelines
The American Urological Association recommends that all men have a discussion with their physician at age 40 about when they should start screening, said Tupelo Urologist Dr. Kris Whitehead. Screening involves a blood test for prostate specific antigen – PSA – and a physical exam. The prostate is a walnut-shaped gland which produces seminal fluid and is located just in front of the rectum.
The PSA alone will catch most early cancers,” Whitehead, but there’s a percentage that we diagnose with a normal PSA and an abnormal exam.”
While there is a normal range for the PSA, it is the change in the PSA from year to year that gives physicians the best information, Whitehead said.
“The rate of change tells us the most,” Whitehead said. “Even with normal values, we are looking for rate of change.”
Early detection has saved lives, but it also means that men and their doctors have a lot of treatment options to consider.
“There’s no consensus on optimal treatment for localized prostate cancer,” Whitehead said. “The majority of men end up with radiation or surgery.”
The recommendations are tailored to the individual, Whitehead said, based on a number of factors such as the stage and aggressiveness of the cancer, the man’s age, health and lifestyle. Some prostate cancers are slow growing, and in some cases, can be managed with watchful waiting, especially in older men
The members of the Man-to-Man Support Group, which is sponsored by the American Cancer Society and hosted by North Mississippi Medical Center in Tupelo, often get lots of questions from newly diagnosed members who are weighing the options.
Because there are so many options for men who are diagnosed with early prostate cancer, the support group sometimes functions as a sounding board for men who are weighing the pros and cons of different types of treatment.
“Some are very curious,” about the experiences of other people who have been through similar procedures, said Boyce Shelton of Tupelo, a Man-to-Man member and 6 year cancer survivor.
Although men aren’t as shy as they once were about speaking about prostate cancer, there’s a broader freedom to talk – and laugh – in the fraternity of the support group.
“You talk about things there you wouldn’t talk about with other people,” Shelton said. “You’re in a group of people who have been the same place you’ve been.”

The options
More than 75 percent of prostate removal surgeries are done with the assistance of robot surgical system. That system – which the surgeon completely controls – allows for a for very precise, minimally invasive surgery.
The goal is to avoid nerve damage could cause men trouble with incontinence or sexual function.
“There’s less blood loss, quicker recovery to normal activities and shorter hospital stays,” Whitehead said.
However, right now, the rate of side effects and complications is similar to open surgery.
“Either option is reasonable,” Whitehead said.
Radiation oncology has also gotten technology boosts over the past few years. Image-guided intensity-modulated radiotherapy allows oncologists to deliver the biggest wallop possible with less damage to the surrounding tissue.
For prostate cancer, they use gold seeds inserted into the prostate, so they can adjust for shifts in the gland.
For men who can’t go through five weeks of daily radiation sessions, radioactive seed implants are another possible treatment,
Cryosurgery, where the prostate is frozen to kill the cancer, is another option. However, because the long range outcomes aren’t as good and the procedure impacts sexual function, it’s not as common as other procedures.
“But it’s reasonable option in older men who are concerned about radition injuries,” Whitehead said.
The next generation of prostate cancer screening – which looks specifically for a cancer marker – is coming closer to reality and will likely change face of prostate cancer treatment, Whitehead said.

More information
Man-to-Man support group for prostate cancer meets at 6 p.m. the first Tuesday of the month at NMMC East Tower first floor Diabetes Treatment Center classroom. The group will not meet in July. Contact Gail Denton at (662) 377-3522 or (800) 843-3375.
Next Meeting: Aug. 2

Free Prostate Cancer Screenings
Urology PA in Tupelo and North Mississippi Medical Center team up each September to offer free prostate cancer screenings. This year, the screenings, which are for men who do not see a urologist on a regular basis, will be Sept. 17 and 24.
Appointments can be made after Aug. 1 by calling (662) 377-7100.