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What Do You Really Know About the Prostate?

Monday, September 29, 2008 at 1:19 AM

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Prostate cancer is the most common cause of cancer among men, and if caught early it's also the most treatable. Still many men remain ignorant about the health of their prostate. Ideastream's Gretchen Cuda talks to a prostate cancer expert to find out what every man should know.

Most men don’t like going to the doctor, a visit to the urologist for a prostate screening?  Forget it.  Sure, prostate cancer is something they’ve heard of, but not likely something they know too much about. 

To test this theory, I decided to ask my own husband what he knew about prostate cancer.  OK first question.

CUDA: Do you know where your prostate is located?
VANDELLI:  uhhh.  Not really.  It’s part of the GI tract

Uhh. Wrong. Dr. Eric Klein is the director of Urologic Oncology at the Cleveland Clinic - and a prostate cancer expert. 

KLEIN: The prostate is part of the endocrine system and male genital system.  It sits at the base of the bladder and its function is to nourish sperm when they leave the body and to keep Urologists in business.

The prostate is a gland the size of a walnut, and it’s normal job is to secrete a clear fluid that protects sperm from the inhospitable environment of a woman’s vaginal canal.  Without it, the fragile sperm would be helpless against the female’s natural defenses, and conception would be all but impossible.  The prostate is essential for the survival of the species.  But it does keep urologists in business.  Nearly every man will get prostate cancer in his lifetime -as long as something else doesn’t kill him first. And lots of men suffer from a non-cancerous condition where the prostate becomes enlarged, presses on the bladder and increases the required trips to the loo. Prostate cancer experts have some serious job security.

OK - next question.

CUDA: What do you know about prostate cancer?
VANDELLI: I know you need to get checked every year, with an exam that is very uncomfortable for a man in general.

Getting warmer. Starting at about age 50, a typical white male should start getting checked - a process that involves a rectal examination - that’s the uncomfortable part --and a blood test for something called PSA. Rising PSA Levels are one indication cancer might be present but are by no means an absolute measure.

KLEIN: PSA stands for prostate specific antigen and it is indeed specific to the prostate, but it’s not specific to prostate cancer.  Other conditions out there can cause an elevation in PSA.

Things like the non-cancerous enlargement of the prostate I mentioned before - a condition known as Benign Prostate Hyperplasia - or BPH.  But even though PSA isn’t perfect, Klein says it’s the most accurate indicator of any tumor that exists, and it’s discovery in the late 1980’s fundamentally changed the way prostate cancer was treated.

KLEIN:  Prior to that time most prostate cancer what diagnosed based on the occurrence of symptoms at an advanced and generally incurable stage, and so we didn’t treat it very aggressively.  PSA allowed us to detect prostate cancer much sooner when it can be easily cured.

And when he says easily cured - he means it - survival rates are 100 percent five years after diagnosis, and 92% after 10 years.  Compare that to lung cancer which has an overall five year survival rate of less than fifteen percent. 

But Early detection and treatment are the key to those survival rates. Among African American men, prostate cancer is 60 percent more common than among caucasian men. Klein says it’s important for African American men and those with a family history of prostate problems to start getting checked a little sooner.

Gretchen Cuda, 90.3

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