Prostate cancer is a serious health problem, but there's good news to report, says Martin Sanda, M.D., a urological oncologist in the University of Michigan Comprehensive Cancer Center.

"Ten to 15 years ago, many men were diagnosed too late to offer them a cure. Today, patients are being diagnosed earlier, with less advanced cancer, when they have an outstanding chance of being completely cured with their first treatment," Sanda says.

In a recent study of prostate cancer patients, Sanda found that more than 99 percent of men diagnosed with low-grade or intermediate-grade cancers who had favorable pre-treatment PSA screening test results were free of any sign of spread or re-occurrence five years after treatment.

A simple two-part screening test -- performed in a physician's office -- is the key to early diagnosis of prostate cancer. The first part is an annual digital rectal exam, which is recommended for all men over age 40. In this painless exam, a doctor inserts a gloved finger in the rectum to feel any lumps or abnormalities in the prostate gland.

The second life-saving screening exam is a blood test for PSA (prostate specific antigen), which is produced by the prostate gland. An abnormally high PSA level is a warning sign for cancer, although infection or other conditions can also cause high PSA levels.

"We recommend PSA screening for healthy men after age 50," says Sanda. "Men with an increased risk of prostate cancer, which includes African-American men and any men with a family history of prostate cancer, should have their PSA levels tested at age 40 or 45."

If screening test results are suspicious, the doctor may recommend that the patient see a urologist for consideration of a prostate biopsy. A biopsy is the only way to confirm whether cancer is present. It is a simple outpatient procedure routinely performed in a doctor's office.

If diagnosis is prostate cancer, Sanda says the doctor will explain the treatment options available, depending on the patient's age and type of cancer. "These include either surgical removal of the prostate gland or radiation therapy or implantation of radioactive seeds in the prostate," he explains. "Moreover, some slower growing types of prostate cancer can be monitored and treatment deferred."

According to Sanda, the University of Michigan Comprehensive Cancer Center is looking for patients to participate in a large clinical trial comparing the side effects of different types of prostate cancer therapies.

"This is a very important study to help physicians determine what treatments are most appropriate for which patients," Sanda explains.

Prostate cancer patients who are interested in volunteering for the clinical study should call the U-M's Cancer AnswerLine at 1-800-865-1125.

It's important not to let fear of side effects, such as urinary incontinence and impotence, prevent men from being screened or treated for prostate cancer, adds Sanda. "This is an appropriate concern for patients, but there have been significant advances in surgical and radiation treatment. Patients now have a much lower risk of long-term side effects than has traditionally been the case."

A recent study by Sanda and other U-M scientists found that meticulous nerve-sparing technique during a radical prostatectomy procedure reduced long-term incontinence rates by half when compared with traditional surgical techniques.

"This technique reduces the percentage of men with significant long-term incontinence to less than 5 percent," Sanda says.

"But not all patients need to immediately be treated for prostate cancer," he emphasizes. "Patients should discuss the timing of treatment with their physician to develop a plan that's suitable for them, their family and their doctor."

Facts about prostate cancer:

· Curable prostate cancers usually cause no symptoms, so screening is essential for detection.

· Although age is a risk factor for prostate cancer, the disease is more dangerous in men in their 50s and early 60s than in older men. This is why it is so important for men to begin screening before the age of 60. Prostate cancer in older men is often a slower growing and less dangerous variety.

· A family history of prostate cancer on either the father's or mother's side increases your risk of developing the disease.

· African-American men have twice the risk of developing prostate cancer as Caucasian men. The disease is most common in North America and northern Europe.

· Prostate cancer is more common in regions with lower exposure to sunlight, such as Michigan, and in regions where diets are high in fat.

Related websites:

U-M Health System Health Topics A to Z: Prostate Cancer

U-M Comprehensive Cancer Center Patient Education Resource Center

U-M Prostate Cancer Home Page

American Cancer Society Resource Center

National Cancer Institute CancerNet>National Cancer Institute CancerNet

(Editor's Note: September is National Prostate Cancer Awareness Month, a good time to remind readers of our Prostate Cancer Archive.)

[Contact: Andi McDonnell]

11-Sep-2000