Prostate Cancer Q&A – Controversial Questions about Prostate Cancer Answered

September 30, 2012 by  
Filed under Prostate Cancer News

If you are one of the many men out there who really are not too clear about the PSA test and other issues about prostate cancer.

This article can provide you with the answers you need. More particularly is the fact that the major areas of controversies in causes, diagnosis, and treatment of prostate cancer were discussed.

An expert in prostate cancer from the Stanford University, in a recent online post, provided valuable answers to most of the controversial aspects prostate cancer:

In recognition of Prostate Cancer Awareness Month, Eila Skinner, MD, chair of the urology department at Stanford, took questions via the @SUMedicine Twitter feed and Scope on prostate cancer and the research advancements in the screening, diagnosis and treatment of the disease. Below she responds to a selection of the submissions, which ranged from the controversy over the PSA test to the ways the field of genetics is changing prostate-cancer research.

@Prach82 and @gaisison ask: Why is the PSA test not considered to be reliable? Is the PSA test still advisable as a basic screening tool for prostate cancer? Are there updates on the recommendations?

PSA (prostate specific antigen) is a protein that was originally discovered at Stanford and can be detected in the blood. Men with prostate cancer tend to have higher levels of this protein. There is no question that prostate cancer can be detected earlier using this test combined with a prostate examination compared with an exam alone. It is estimated that the cancer can be detected on an average of 5 to 10 years earlier. It is also clear that cancers detected with PSA screening are more likely to be caught before they spread and at a stage when they are more likely to be cured with current treatments. So why the controversy?

First, men with other common prostate problems, like non-cancerous prostate enlargement (called BPH) can have an elevated PSA. Because of this only about 20-30 percent of men with elevated PSA on screening actually have cancer. They often have to undergo invasive testing like prostate biopsy in order to know that there is no cancer there. These tests are expensive and can sometimes cause side effects like infection. We are always searching for a more accurate test to use for screening, and a number of potential alternatives are being developed. Some are already available, like the urine PCA3 test. This test is still very expensive and has not yet gained widespread use as a screening tool.

Secondly, prostate cancer is usually very slow growing. It might take 10 to 30 years for an early cancer to become one that is life threatening. The risk of cancer goes up with age, so many of the men diagnosed with cancer using PSA testing at age 70 or 80 are never going to live long enough for their cancer to cause problems. Many patients are undergoing treatment today, such as surgery or radiation therapy, for cancers that are not destined to threaten their life.

Finally, we still don’t have proof that if every man got tested, even at age 50 or 60, they would end up living longer than ones who didn’t get tested. Current studies trying to test this have been difficult to complete. They suggest that there may be some benefit, but 40 or more men may have to be treated to save one life. Because the treatment can cause significant side effects, it isn’t clear if this is worth it from a public health perspective.

Still, we shouldn’t give up on the PSA test. We need to be smarter about using the test and learning how to predict how a cancer is going to behave in an individual patient. In other words, use the test to find the cancer, but don’t treat everyone’s cancer the same way. Many cancers can be safely watched, thus avoiding the side effects of treatment. On the other hand, the patient with an aggressive cancer that is picked up earlier might be saved with treatment.

At this point, I’d recommend that you discuss the pros and cons of testing with your doctor.

GS asks: Previous research has found that men who eat one and a half servings of pan-fried red meat weekly have a 30 percent higher risk of being diagnosed with advanced prostate cancer. How does eating certain foods increase or decrease you prostate cancer risk?

There have been a number of dietary studies (subscription required) demonstrating a relationship between the intake of red meat and the risk of prostate cancer. Most studies have shown that processed meats, such as hamburger and grilled meats, have the highest risk. These meats seem to particularly increase the risk of more aggressive cancers. Cooking meat to high temperatures on a grill or barbecue, especially when charring occurs, may increase the production of heterocyclic amines and polycyclic aromatic hydrocarbons, both of which are known carcinogens. White meats, such as chicken, and fish can generate these compounds as well. But they tend to be cooked more quickly, have less charring and generally haven’t been associated with an increase risk of prostate cancer. Marinating meat before cooking can decrease these compounds. To decrease risk of prostate cancer, eating red meat that is rare or cooked at lower temperatures or eating less red meat and opting for white meats, such as chicken, or fish may be safest.

There are still many questions about diet and prostate cancer prevention and treatment, though a few large studies have been completed. Sometimes we have seen opposite effects than we expected. For example, earlier studies suggested high selenium intake might prevent prostate cancer. But the SELECT study of over 30,000 men showed that men who took supplemental selenium did not have less prostate cancer but actually developed more diabetes! Other studies have suggested benefits of some dietary intake such as soy protein and pomegranate juice, but these have not been confirmed by larger studies.

The best advice for men is to follow a heart-healthy diet. Heart disease is still by far the greatest threat to men’s health, and evidence suggests that a heart-healthy diet, which is high in vegetables and fruits and whole grains, low in saturated fats and red meat, is also the best diet for prostate cancer prevention. Click here to read view more questions and answers.

So, from the above excerpt, you should have some of your questions about prostate cancer answered.

The expert from the Stanford was elaborate enough with the explanations that anyone will understand all about prostate cancer.

Even from the above, a novice to prostate cancer will begin to form an opinion and become decisive about cancer of the prostate.

What were discussed above reveal what to do to increase or decrease the risk of prostate cancer. This for sure is one of the best highlights of the prostate cancer awareness month.

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