This article appears in Winter Boomers magazine.
About 1 in 9 men will be diagnosed with prostate cancer during his lifetime, making it the second-most common cancer in America after skin cancer.
Dr. Christopher Saigal, vice chairman of urology at UCLA Health, urges men to get the facts and make careful decisions about treatment.
PSA tests are Step 1
Prostate-specific antigens, or PSA, are harmless proteins made by the prostate gland. In men with prostate cancer, the prostate overproduces these proteins, but PSA tests don’t confirm whether you have cancer, Saigal said.
“The PSA test can be a helpful component in screening, but most men with elevated PSA do not have prostate cancer,” he said.
There are a number of reasons why PSA levels may rise, including aging, size of the prostate gland and infection or inflammation of the gland, Saigal said.
“About one-fifth of men with elevated PSA levels have prostate cancer. The only way to know for sure is through a biopsy,” he said.
Side effects beyond sexual function
“When it comes to the side effects of treating prostate cancer, the spotlight falls on sexual functions, but other side effects should factor into treatment decisions, too,” Saigal said.
Depending on course of treatment, side effects can include urinary incontinence or issues with bowel health.
“Some men who choose active surveillance to monitor their prostate cancer develop anxiety from the process, even though active surveillance is a very useful option for many men,” he said.
Shorter treatment now
One of the newest forms of treatment for prostate cancer is stereotactic body radiotherapy, or SBRT. Traditional therapies have included small doses of radiation over the course of several weeks, which can be burdensome on men who have to travel or live far from treatment centers. Newer SBRT is quicker and can last as little as five days, Saigal said. Physicians precisely target a greater dose of radiation to minimize the damage to adjacent tissue and avoid damage to the bladder and rectum, Saigal said.
Make shared decisions
“When making decisions about treatment, take the time so your goals and values are understood by your doctor,” Saigal said. “There are many ways to treat prostate cancer. Care has to be personalized. It’s called shared decision making. If you don’t think you’re getting it, if your doctor is not taking the time with you, you have time to make a change.”
You’ve got time
“Prostate cancer is not a ticking time bomb. In most cases you have a couple of months to make a plan that’s right for you. Waiting a few months to decide what treatment is best for you in general does not affect treatment cure rates. When it comes to prostate cancer, research has shown that a significant proportion of patients come to regret their treatment decision. Take the time you need to pick the treatment that’s right for you,” Saigal said.