Prostate Cancer Survivors Emphasize Importance of Crucial Screening Tool
by TERESA SCHIFFER
Among men in the U.S., prostate cancer is the second most common cancer. When it was first discovered by surgeon J. Adams at The London Hospital in 1853, it was considered “a very rare disease.” It took about 50 years for doctors to be able to differentiate prostate cancer more accurately from other problems that could cause urinary obstruction.
Over time, as diagnostic techniques have been developed and refined, the incidence of prostate cancer began to rise, primarily due to the increased ability to detect the disease. This increase in detection has made it possible for doctors to act in time to prevent many deaths.
Testing for prostate cancer has declined in recent years, as medical researchers have learned that in many cases, there is no real need for treatment. That’s because prostate cancer is often so slow to progress that many men who are diagnosed with the disease ultimately pass away from an unrelated cause before the cancer causes any real issues.
Prostate cancer is far more prevalent in older men than in younger men, with roughly 60 percent of all cases occurring in men 65 and older. It is rarely seen in men younger than 40. Age, ethnicity, and family history are the biggest risk factors. Globally, black men in the United States and the Caribbean have the highest incidence of prostate cancer.
Dr. Wasif Riaz is an oncologist with Florida Cancer Specialists & Research Institute. He sees patients with many types of cancer, including men diagnosed with prostate cancer. He describes the usual symptoms they experience and how the disease initially presents.
“They may have mostly urinary symptoms,” he says. “Sometimes they may have difficulty urinating, or sometimes they get up a lot at night to urinate because they’re unable to completely empty their bladder. Sometimes they may have blood in the urine.”
When these symptoms are present, an individual’s doctor may want them to see a urologist and have screening for prostate cancer performed.
“Generally, it gets diagnosed through a biopsy,” Riaz explains. “When we are suspecting prostate cancer, many times doctors and urologists will order a PSA test. If the PSA is high, then we are really suspecting it and will recommend a biopsy then.”
A PSA test is a blood test that measures the amount of prostate-specific antigen (PSA) present in a man’s system. A high level of this protein can indicate that cancer may be present in the prostate, though it is not definitive.
Kenneth Lucas, 74, was alerted to the presence of cancer in his prostate during a routine PSA screening about 10 years ago. The Sebring resident’s PSA was 39.6; a level between 4.5 to 5.5 is considered normal for men between the ages of 60 and 70. Before his diagnosis, Lucas did not have symptoms.
“I was fine,” he recalls. “I had no idea there was anything wrong.”
Lucas had his prostate removed, and aside from a couple of days in the hospital following the surgery. No further treatment was required. He has his PSA tested every three months and has had no further issues in that department.
He recommends that men not hesitate when it comes to getting screened.
“I would say get tested – go get your PSA tested. I wasn’t doing that, and my PSA was very high when I had the surgery done,” Lucas urges.
Robert Glade, 69, was diagnosed in 2019, when he visited his doctor to address gout in his finger. He had never had his PSA tested before, and his level was found to be 50. His healthcare team suspected the cancer had been present for about three to five years already at that point, and it had spread to the Lake Wales resident’s pelvic bone.
Glade received 44 days of radiation treatment for the cancer in his prostate and pelvic bone. Once that was completed, he was given a shot of Lupron hormone therapy twice a year.
When Riaz took over Glade’s care, he found that his PSA levels were again climbing, so he ordered a PET scan and MRI. Riaz prescribed Xtandi, an anti-androgen (anti-testosterone) medication used to treat prostate cancer.
Glade has been taking the Xtandi for about a month and his PSA levels are decreasing to a nearly undetectable level. Riaz assured Glade that the Xtandi medication should also halt the growth of two small spots that have been detected in his lungs and may even reverse their development.
The Xtandi does have some negative effect on muscle tissue, so Glade makes sure to stay active to prevent excessive loss of strength. He agrees with Lucas that men need to be proactive about getting screened.
“I’ve been giving advice to people 50 years old since I found out about this,” Glade says. “I’m like, ‘Man, just go in and get a PSA test. It’s a blood test. That’s all it is.’”