Prostate Cancer

Prostate cancer is the number two cancer killer in men. According to the American Cancer Society, more than a quarter of a million cases of prostate cancer are diagnosed each year. Although these figures are alarming, prostate cancer results in 27,000, or about 10 percent, of cancer deaths, per year. "While a lot of people are diagnosed with prostate cancer, the good news is that very few actually die from it," says Daniel Zapzalka, MD, urologist, Park Nicollet Clinic-St. Louis Park. "Improved treatment and screening has resulted in fewer deaths, but early detection gives the best chance of survival," he adds.

Screenings important for successful treatment

Routine screenings are key to early diagnosis and, ultimately, are the most effective treatment. During a basic screening, patients are given a blood test known as a prostate-specific antigen (PSA) and digital rectal exam. "We really want to be more aggressive about screening, especially with men in a high-risk group," Dr. Zapzalka says. Men at risk include those:

in their 50s and 60s;
with a family history of the disease;
who are black; and
who eat a high-fat diet.

"I usually recommend aggressive, yearly screening for men ages 50 to 75," Dr. Zapzalka says. "And if a patient has a family history of prostate cancer, I may recommend screening as early as age 40." If prostate cancer is suspected after a screening, an ultrasound and biopsy can determine if cancer is actually present.

Symptoms

Early stage prostate cancer often shows no symptoms. In some cases, however, it may cause pelvic pain, bloody urine, pain during urination, difficulty starting urination, reduced appetite and weight loss.

Treatment options

If cancer is detected, many treatment options exist. Treatment often is determined by the patient's age and health, and the aggressiveness of the cancer, Dr. Zapzalka says. Options for early prostate cancer are usually prostatectomy (surgically removing the prostate) or radiation therapy. "If the patient is young and healthy, surgery is a better long-term solution; if the patient is older and still healthy, we may recommend radiation," he says. Occasionally, cryotherapy (freezing of the prostate), watchful waiting (observation without treatment) or hormonal therapy also may be options - based on the circumstances.

Reduced complications

Although urinary incontinence and sexual dysfunction were common prostate cancer treatment complications in the past, they have been greatly reduced. "We have worked hard to decrease the side effects of surgery. We also have refined techniques and have newer methods for targeting and delivering radiation," Dr. Zapzalka says. "We have made huge strides to more effectively treat prostate cancer and reduce complication rates."

The success of prostate cancer treatment also has greatly improved in recent years, and most men fully recover and live long, healthy lives. "Nowadays, the majority of men diagnosed with prostate cancer may need treatment, but hopefully it is not going to greatly affect their quality of life," Dr. Zapzalka says.