Approximately one in eight men will be diagnosed with prostate cancer, the second most common cancer in men in the United States after skin cancer, according to the American Cancer Society (ACS).
But most men diagnosed with prostate cancer do not die from it, and advances in treatment have led to much better outcomes and survival rates even for those with advanced and aggressive cancers.
The biggest risk for developing prostate cancer is advancing age. Prostate cancer is rare in men under 40, and according to the ACS the average age of diagnosis is 67.
There has been a lot of research and interest in the relationship between diet and prostate cancer, said Endeavor Health oncologist Daniel Shevrin, MD, a prostate cancer expert. There is some evidence that adhering to the Mediterranean diet may reduce the risk of prostate cancer. This diet consists of fruit, vegetables, whole grains, fish, healthy oils, and limited red meat. There is evidence that this is a heart-healthy diet.
Screening
A family history, meaning one or more first degree relatives with prostate cancer, puts men at a higher risk and suggests the need for earlier screening for the disease. African American men are also at a higher risk of developing prostate cancer and should consider earlier screening as well, said Dr. Shevrin.
“The decision to undergo screening for prostate cancer is a very individual one and should include a detailed discussion with your primary care physician about the risks and benefits,” said Dr. Shevrin.
Multiple expert groups recommend screening with a prostate-specific antigen (PSA) blood test for men between the ages of 55 and 70. The acceptance of active surveillance as a viable option to immediate treatment has made the screening decision an easier one for many men.
Active surveillance
Active surveillance includes regular PSA testing and periodic prostate biopsies and provides an active way to monitor cancer for appropriate patients, explained Dr. Shevrin. Historically, early detection efforts led to over-diagnosis and potential negative impacts on quality of life with treatment that may not have been warranted for slow-growing cancers.
Staging and treatments
For prostate cancers that warrant treatment, surgery and radiation are still the gold standard approaches. Advances in minimally invasive, robotic surgery and the combination of newer hormone therapy and radiation have led to improved outcomes.
Advanced imaging with MRI scans of the prostate and whole-body PET scans have led to more accurate staging of prostate cancer. This information leads to much better treatment recommendations that translate to better outcomes.
Sophisticated genomic testing has now become standard for many men with prostate cancer. This includes germline testing to identify inherited genetic mutations associated with elevated prostate cancer risk that can help family members determine if they have a higher risk and would benefit from early screening.
Genomic testing also includes testing of the tumor (via blood tests or tumor tissue) to identify mutations in the cancer cells that can lead to treatments targeted to these mutations (known as personalized medicine).
Recent advances including new medications and novel treatments for advanced prostate cancer are providing hope for patients and families and optimism for specialists like Dr. Shevrin.
Radioactive drugs that bind specifically to prostate cancer cells are proving very effective and very well tolerated for patients with advanced prostate cancers.
“We’re also looking at better ways to use existing drugs earlier in the course of treatment and in combination with other medications to improve outcomes and reduce side effects,” said Dr. Shevrin.
One in eight American men will be diagnosed with prostate cancer in their lifetime. If you or a loved one is diagnosed with prostate cancer, you’ll find expert, comprehensive care close to home at Endeavor Health Cancer Institute. Learn more.
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