A Public Health Concern - Prevention, Detection, Symptoms & Decisions

The Facts • About 80% of all diagnosed prostate cancers are in men aged 65 years of age or older. • Fewer than 10% of men with prostate cancer die within five years of the diagnosis. • African-American men have the highest rates of prostate cancer mortality. • Asian/Pacific Islanders have low rates of incidence and mortality. • Death rates decreased from 1990-1998 for all racial/ethnic groups except American Indian/Alaska Natives

In 2002, the American Cancer Society estimates that 189,000 new cases of prostate cancer will be diagnosed and 30,200 men will die of the disease. In Wisconsin, 4,000 new cases of prostate cancer will be diagnosed and 600 men will die.

Prostate cancer is the second leading cause of cancer death among men, with over 80% of all cases occurring in men over age 65.

At all ages, African-American men are diagnosed with the disease at later stages and die of prostate cancer more often than do white men. The reasons for the greater incidence and mortality among African-American men are unknown.

Read more about who is at risk.

Prostate Cancer Deaths
The average annual age-adjusted mortality rates for prostate cancer deaths per 100,000 men, by race, 1995-1999

	Wisconsin	National
Overall	35.5	33.9
White	35.0	31.2
Black	64.1	72.8
Hispanic	-	21.6
Asian/Pacific Islander	-	14.3
American Indian/Alaska Native	-	17.5

Source: Centers for Disease Control and Prevention

Can Prostate Cancer Be Prevented?

Researchers are trying to find out what causes prostate cancer and if it can be prevented. While all researchers do not agree on what impacts a man's risk, investigators are studying:

• Use of herbal supplements.
• Diets high in fat or low in fruits and vegetables.
• Consumption of vitamin E or selenium.
• Certain infectious diseases.
• Men's hormonal characteristics

Click here for more information about prevention.

How Is Prostate Cancer Detected?

The two most common tests used by doctors are the digital rectal exam and the prostate specific antigen test.

• The Digital Rectal Exam (DRE) has been recommended for years as a screening test for prostate cancer, yet it is limited in its ability to detect prostate cancer or distinguish a cancer from something else.

• The Prostate-Specific Antigen (PSA) is a blood test that measures the PSA enzyme. The PSA test is limited in its ability to distinguish between a benign and cancerous tumor and other conditions, e.g., prostatitis (inflammation of the prostate).

There is no scientific consensus on whether screening and treatment of early stage prostate cancer reduces mortality. Every man has a right to discuss the pros and cons of prostate cancer screening and treatment with his doctor. It is his right to make his own decision about screening.

Click here for more information on screening and tests.

Recognizing Symptoms

Early prostate cancer often does not cause symptoms. But prostate cancer can cause any of these problems:

• A need to urinate frequently, especially at night;
• Difficulty starting urination or holding back urine;
• Inability to urinate;
• Weak or interrupted flow of urine;
• Painful or burning urination;
• Difficulty in having an erection;
• Painful ejaculation;
• Blood in urine or semen; or
• Frequent pain or stiffness in the lower back, hips, or upper thighs.

Any of these symptoms may be caused by cancer or by other, less serious health problems, such as Benign Prostatic Hyperplasia (BPH) or an infection. A man who has symptoms like these should see his doctor or a urologist (a doctor who specializes in treating diseases of the genitourinary system).

The doctor may order exams to learn more about the cause of the symptoms. If a man has symptoms or test results that suggest prostate cancer, what lies ahead?
Read What does a diagnosis of prostate cancer mean to me?

Treatment for Prostate Cancer
Getting a Second Opinion

Decisions about prostate cancer treatment involve many factors. Before making a decision, a man may want to get a second opinion by asking another doctor to review the diagnosis and treatment options. A short delay will not reduce the chance that treatment will be successful. Some health insurance companies require a second opinion; many others will cover a second opinion if the patient requests it. There are a number of ways to find a doctor who can give a second opinion:

The patient's doctor may be able to recommend a specialist or team of specialists to consult. Doctors who treat prostate cancer are urologists, radiation oncologists, and medical oncologists. Patients may find it helpful to talk to a specialist in each of these areas. Different types of specialists may have different thoughts about how best to manage prostate cancer.

The Columbia St. Mary's Physician Referral Line (414) 963-9355, can tell callers about treatment facilities, including cancer centers and other programs supported by their physicians.

Advanced Healthcare's 24-hour Advanced HealthLine can help you find specialists and board-certified physicians at (262)-512-2880 or toll-free outside the metro Milwaukee area at (888) 709-2080.