New Study Suggests That Black Men Should Start Prostate Cancer Screening Earlier

New findings suggest that the disease progresses faster in this demographic.

Some researchers now believe that black men may merit their own race-specific screening guidelines due to studies that have shown that they have a higher risk of developing — and dying from — prostate cancer.

Compared to white men, the incidence of prostate cancer is 60 percent higher among black men in the U.S. Also the death rate from prostate cancer is more than twice as high for black men than white men in this country, and the prostate cancers in black men tend to progress faster.

Based on these statistics/facts, some researchers believe that black men merit their own race-based screening guidelines. Other experts disagree with the idea of race-based screening guidelines.

Some experts strongly believe that black men should start talking to their physicians about prostate cancer screening at an earlier age; in their 40’s vs. their 50’s. Most standard guidelines suggest that these talks begin when a man is in their 50’s. Black men may also benefit from more frequent screening.

In the U.S. prostate cancer is the leading cancer diagnosis for men. It is also the second leading cause of cancer death for males in this country.

Because screening can sometimes lead to unnecessary treatment, it can be a source of controversy among medical experts. Many experts feel that there should be specific clinical guidelines written that are specific to black men.

PROSTATE CANCER SCREENING

When it comes to prostate cancer, screening usually consists of a blood test to measure the level of prostate-specific antigen (PSA) and a digital rectal exam to check the prostate gland for enlargement or other abnormalities.

If a PSA level is above 4.0 nanograms per milliliter (ng/mL) of blood it is considered high, according to the U.S. National Cancer Institute.

The U.S. Preventive Services Task Force has recently proposed new recommendations for prostate cancer screening. It now suggests that men in their 50s should start a discussion with their doctor about the risks and benefits of screening. According to this task force, whether a man gets screened or not should be an individual, informed decision.

Study Finds That Taller And Heavier Men Are More Likely To Get Prostate Cancer And Die From It.

BMI, which is body-mass index together with waist circumference were recently studied as how they relate to prostate cancer. The results show that both factors can directly predict risk of developing high-grade prostate cancer.

A new study suggests that the larger a man is, the greater his risk of getting and dying from aggressive prostate cancer.

Each additional segment of 4 inches of height increased a man’s chances of being diagnosed with high-risk prostate cancer by 21 percent. Researchers found that this also increased their odds of dying from prostate cancer by 17 percent.

The size of a man’s waist yielded similar results in the study. With every 4-inch increase in waist circumference, the odds of developing aggressive prostate cancer were increased by 13 percent.The risk of dying from prostate cancer using this waist measuring criteria, increased by 18 percent.

The study researchers came to their conclusions based on data from nearly 142,000 men in eight European countries who participated in a large-scale study of cancer and nutrition.

There have been previous studies done that have suggested a potential link between prostate cancer and a man’s height or weight, but this study is the first to assess whether those factors influence the risk of being diagnosed with either a slow-growing or aggressive cancer.

As a statistic measured on its own, height by itself was not linked to a man’s overall risk of developing prostate cancer, nor was it associated with risk of being diagnosed with low- or intermediate-grade prostate cancer.

The results of the study did show that height did indeed influence a man’s risk of being diagnosed with aggressive prostate cancer and of dying from prostate cancer.

Along the same lines, body-mass index and waist circumference were both shown to directly predict risk of developing high-grade prostate cancer.

This particular study only found an association between height, weight and aggressive prostate cancer risk; it couldn’t prove a cause-and-effect link.

The association between height and prostate cancer risk isn’t a new finding. Researchers have long suspected that the increased risk from height could possibly be related to early childhood nutrition that promoted fast growth.

There are some theories in regards to the possible link between obesity and prostate cancer. One is that obesity influences hormones in the body in a way that promotes prostate cancer. The second is that it may simply be more difficult to catch prostate cancer early in men who are obese partly because the digital rectal exam is more difficult to do. If the men have a large prostate it’s easier for a doctor to miss something during an exam.

Another contributing factor could be that PSA blood tests for prostate cancer are less reliable in obese men, because they tend to have a higher volume of blood that dilutes and masks elevated levels of prostate-specific antigen.

The 15-year survival rate of men diagnosed with prostate cancer is 96 percent, according to the American Cancer Society.

The study was published July 12, 2017 in the journal BMC Medicine.

A High PSA Level Can Indicate Less Serious Conditions Than Prostate Cancer

The first sign of prostate cancer can certainly be a high PSA level, but it can also be a sign of a less-serious condition.

Here are some reasons you may have an abnormal PSA reading:

1. PSA Levels Are Affected By Age

Your PSA level can increase gradually as you age even without any prostate problems. At age 40, a PSA of 2.5 is the normal limit but by age 70, a PSA of 6.5 could be considered normal.

2. Many Men Under 50 Suffer From Prostatitis

Prostatitis is the most common prostate problem for men younger than 50. Common causes of inflammation in the prostate gland, called prostatitis, can cause high PSA levels.

3. PSA Can Be Elevated Due To Medical Procedures

Anything that traumatically interferes with the architecture around the prostate gland can make PSA go up such as placing a catheter into the bladder. A bladder exam that involves passing a scope or taking a biopsy can also affect PSA levels.

4. BPH May Be the Cause of High PSA In Men Over 50

Benign prostatic hyperplasia (BPH) is an enlargement of the prostate gland. BPH means more cells, so that means more cells making PSA. BPH is the most common prostate problem in men over age 50. It may not need to be treated unless it’s causing frequent or difficult urination.

5. Urinary Tract Infections Can Create High PSA Levels

Any infection near the prostate gland such as a urinary tract infection, can irritate and inflame prostate cells and cause PSA to rise. If you’ve been diagnosed with a urinary tract infection, be sure to wait until after the infection has cleared up before you get a PSA test.

6. Ejaculation Can Be a Potential Cause of Mildly Elevated PSA

Ejaculation can cause a mild elevation of your PSA level. This type of PSA elevation is usually not enough to make a significant difference unless your PSA is borderline.

Arnold Palmer And Other Famous People Diagnosed With Prostate Cancer

The American Cancer Society estimates that 161,360 new cases of prostate cancer will be detected in 2017. Many famous men including actors, politicians and sports figures have been diagnosed with prostate cancer, and their diagnoses can help to build awareness for the disease.

The following is a list of only some of the celebrities who have coped with prostate cancer:

• Arnold Palmer: Golfer (see below for Arnold Palmer’s story)
• Harry Belafonte: Singer and actor
• Bob Dole: Former Republican senator from Kansas
• Robert De Niro: Actor and director
• Rudy Giuliani: Former New York City mayor
• Charlton Heston: Actor
• John Kerry: United States Secretary of State since 2013
• Nelson Mandela: Former president of South Africa and anti-apartheid activist
• Francois Mitterand: Former president of France
• Roger Moore: Actor
• Colin Powell: Retired Secretary of State
• Frank Zappa: Musician

Arnold Palmer’s Prostate Cancer Story

Following his own diagnosis, Arnold Palmer became a champion for prostate cancer. His cancer was originally detected based on a rising PSA test, and confirmed with a prostate biopsy. He chose a radical prostatectomy for treatment and remained cancer free until the end of his life in September 2016.

Known for being a world-renowned professional golfer, Arnold Palmer had won dozens of PGA Tour events. He also is recognized for his involvement in politics, such as his personal relationship with President Dwight D. Eisenhower, and his charity work and community outreach, including working with foundations such as the Eisenhower Medical Center Foundation and the March of Dimes.

Arnold Palmer became known as a champion off the greens as well, for his work raising awareness about prostate cancer.

Palmer’s Prostate Cancer Diagnosis

In 1997 Palmer was diagnosed with prostate cancer. He had been getting routine physicals that included a PSA test. Because his PSA result rose steadily with each passing year, his physician ultimately recommended performing biopsies. Initially, these tests showed no evidence of cancer, though the PSA continued to rise in subsequent exams. However in 1997 one biopsy in came back showing the early stages of cancer. The biopsy was confirmed at the Mayo Clinic and he received a diagnosis of prostate cancer.

Palmer chose to undergo a radical prostatectomy to remove his prostate entirely. This was followed by radiation therapy treatments that lasted for seven weeks.

Within two months post-treatment, Palmer was back on the golf course and getting back in tour shape. Palmer did say that he noticed that post-surgery and radiation that he was weaker than he had previously been and that he required a longer time to recover after his practices.

Spokesman for Prostate Cancer Awareness

After his treatment in 1997, Arnold Palmer was at the forefront of prostate cancer awareness and was very public and vocal about his support of PSA testing.

Palmer strongly recommended that men not wait until their 50s to get screened for prostate cancer, and often reiterated that choosing to get this simple blood test can help save a life. He was a true example of someone for whom early detection of the disease proved life-saving.

As part of his prostate cancer advocacy, Palmer founded the Arnold Palmer Prostate Center at the Eisenhower Lucy Curci Cancer Center within the Eisenhower Medical Center near Palm Springs, Calif. This is a non-profit center that offers state-of-the-art prostate cancer treatment options.

In 2002 his dream of opening a cancer research facility in his hometown of Latrobe, Pennsylvania was realized when the University of Pittsburgh Medical Center and Latrobe Area Hospital unveiled the Arnold Palmer Pavilion. This cancer treatment center, a 30,000 square-foot addition to Latrobe Hospital features outpatient oncology and diagnostic testing.

Though Arnold Palmer died on September 25, 2016 of complications from heart problems, his name continues to be linked to prostate cancer awareness.

Surgery Seen as Superior to Radiation Therapy in Younger Men with High-risk Prostate Cancer, Study Finds

A recent study concluded that men under age 60 with high-risk prostate cancer who underwent radical prostatectomy; or surgery to remove all or part of the prostate; as an initial treatment, showed significantly improved overall survival at four years than those given radiation therapy.

Researchers used the National Cancer Database to analyze 16,944 high-risk prostate cancer patients, age 59 or younger, who had Gleason scores of 8 to 10 with no metastasis or nodal involvement. The study included data collected between 2004 and 2013.

Of the study population, 12,155 men had radical prostatectomy, and 4,789 had external beam radiation therapy (EBRT) — alone or in combination with brachytherapy — as a first therapy. In 82.5 percent of radiation-treated patients, hormone therapy was also used. Post-operative radiation therapy was given 17.2% of those who had a radical prostatectomy.

After a median 50-month follow-up, statistical modeling was used to determine differences in overall survival between the two groups, and found a significant 48 percent improvement in those who underwent surgery. The estimated survival rate at eight years was also higher in this group, 85.1 percent versus 74.9 percent, respectively.

“When a younger man has high-risk prostate cancer, it generally makes sense to choose surgery over radiation,” a prostate cancer surgeon and urologic oncologist said in a recent press release. “Radical prostatectomy has many advantages over radiation which include shorter recovery times, less pain, and from what this study is showing, the prostate cancer is removed with a higher cancer control and survival rate.”

The findings were presented at the 2017 American Society of Clinical Oncology Annual Meeting, which took place in Chicago in early June. The study was published in the Journal of Clinical Oncology, under the title “Survival impact of initial local therapy selection for men under 60 with high risk prostate cancer.”

It concluded: “Compared to RT [radiation therapy], initial treatment of men under 60 with high risk PCa [high-risk prostate cancer] with RP [radical prostatectomy] results in a large, statistically significant improvement in overall survival that remains consistent over time and remains significant in a multivariable model adjusting for known prognostic variables.”

Shortcomings noted by the study’s researchers included its retrospective nature as a database analysis, and a lack of cancer-specific survival information.

Social Media Is Helping To Support People Diagnosed With Cancer

The digital age has changed the way we live, the way we work and now it has also changed the way we view cancer. In addition to offering a world of information, the internet can offer hope, solace and support to cancer patients.

On Twitter, clicking a hashtag like #prostatecancer can instantly return thousands of people who are going through prostate cancer. It can also lead patients to helpful information about the latest treatments or clinical trials.

There are also Facebook groups that offer a safe haven for patients to share some of the thoughts and fears that they might not feel comfortable sharing with their family, friends, or even doctors.

Support groups whether in-person or online can also serve as passive places to read and digest other people’s experiences with cancer. Many patients benefit in the feeling that they are “not alone”.

A columnist for the Lymphoma News Today shared a story online about how the fellow lymphoma sufferers she met online have become her closest friends; so much so that they served as bridesmaids in her wedding. She told about how the strength she drew from online support helped her through the darkest times. She said that in her experience, social media became her safe haven.

In addition, blogs, YouTube channels, and Instagram accounts allow users to reach out to others with cancer in faraway places. Many patients report that they have made lasting friendships that endure way beyond their final rounds of chemotherapy or final cancer treatments. Social media has made a huge impact; becoming the 24-hour support group patients need. Patients are comforted when they can reach out and touch and be touched by people who truly understand what life with cancer is like.

Social media also empowers cancer sufferers to share their knowledge and empower themselves and others. Sharing knowledge through online outlets helps patients make informed decisions and be more proactive about their treatments. Today’s patients often bring up new treatment ideas with their doctor; vs. the not so distant past where they were more likely to wait for their doctor’s suggestions.

Your Job; How it Can Be Affected by Prostate Cancer

Many patients are very concerned about keeping their job after receiving a prostate cancer diagnosis.

It can require quite a bit of time away from work once a patient is undergoing prostate cancer treatment. Money and health insurance are two pressing concerns for any patient during prostate cancer treatment, so how it will affect your job is an important consideration.

Prostate Cancer Diagnosis; What About Missing Work?

Whether you have surgery, hormone therapy or radiation treatment to treat prostate cancer, there will be side effects of each that may require you to miss work. Most patients need time off to have surgery and recover (anywhere from a week to more than a month), and radiation treatment appointments for prostate cancer may cause you to miss work regularly for a long period.

It is important to consider the options your employer offers to allow time off to take care of your health.

• FMLA. The Family and Medical Leave Act is a federal law that allows you up to 12 weeks off work, unpaid, to take care of a health condition. There are conditions to such leave: Your employer must have 50 or more employees, and you must be a full-time employee. You are also required to have been employed by the company for at least one year before you can take FMLA. Ask your employer if you qualify.
• Disability pay. Your employer may offer short-term or long-term disability, or your state government may provide it. These programs allow you to receive a certain percentage of your pay if you are unable to work because of a health condition. Ask your employer if any disability pay is offered through your benefits. Disability insurance policies can be bought independently; ask an insurance agent or a financial planner.
There will also need to be time devoted to managing health care bills and the paperwork relating to your prostate cancer treatment for insurance purposes. You will want track doctor’s visits, hospital visits, treatment dates, and medications that you’ve taken and received. Develop a good filing system so you can. Develop a good system to file all paperwork from your health care providers and your insurer.

Co-Workers May Be Glad To Lend Their Support

You may find that co-workers are a great source of support during and after prostate cancer, and you should tell them as much or as little about your situation and prognosis as you are comfortable with.

Keeping Up With Your Work During Prostate Cancer Treatment

It is a good idea to try to keep up with your work as much as you are able to while you’re out, or during your intermittent time out of the office. Try to talk to colleagues about handling some of your work, and make sure that meetings and deadlines aren’t missed while you’re gone; if possible, see if someone else can cover for you. Many patients also try making a to-do list of everything that you’re working on, so that your manager and co-workers are kept up to date.

If you can investigate the work-related benefits available to you early after your diagnosis can provide peace of mind. If you can keep the communication lines open at work you’ll feel more comfortable knowing that people are there for you.

Caring for a Partner With Prostate Cancer

How to Care for a Partner With Prostate Cancer

The whole world can seem to change in an instant when a you find out that your partner has been diagnosed with prostate cancer. Both of you will probably feel overwhelmed, and afraid. It will most likely be a confusing time for both of you.

The Best Thing to do is to Learn What to Expect

You both should take steps to educate yourself about the disease. In this case knowledge can certainly be power. There are many possible side effects of both the cancer and the types of treatments that you should be prepared for. These can include:

Infertility.
A man can be rendered infertile due to prostate cancer treatment, whether it be surgery or radiation therapy. For partners that want to have children after treatment, if is recommended to investigate options such as sperm banking pre-treatment.

Sex life changes.
It is common for men to experience erectile dysfunction (impotence) after treatment for prostate cancer. It may be temporary or permanent depending on the treatment.

Changes in urination/bowel issues.
Lack of control/urinary incontinence can be a common after prostate cancer treatment. Bowel issues such as diarrhea can be long-term effects of some kinds of radiation therapy.

Hormonal changes.
Numerous side effects can occur from the hormone therapy used to treat prostate cancer. These side effects can include weight gain, and muscle loss, fatigue, low sex drive, hot flashes, and brittle bones.

Subtle hormonal changes could be evident as well including memory and multi-tasking difficulties. For example, hormone deprivation therapy can potentially have some subtle, cognitive (thought process) effects in the men prescribed this treatment. The knowledge you can gain about the types of side effects that can occur, and what you can do about them, can empower you and help you and your partner know when/how to take action.

Prostate Cancer Caregiving: More Tips
Your partner will need you to be there to listen. Make sure to encourage him in his treatments by going to doctor’s appointments, treatment sessions, and tests. Make sure that he knows that you want to be a part of this process with him. You are the best person to encourage him to look forward to the life he can enjoy once his treatments are completed and successful.

You Are Important Too
Some find it helpful to join a group for caregivers of prostate cancer patients. It can be a good place to share your experiences with others.

When You Have Prostate Cancer Make Physical Activity a Priority

From improving your mood to helping you fight fatigue; physical activity can have lots of benefits when you have prostate cancer, from improving your mood to fighting fatigue. Physical activity doesn’t have to mean something of the level of running a marathon or climbing a mounting. There are many small ways to encourage yourself to get more active; move more. Talk to your doctor and ask for a good exercise plan that meets your personal needs.

Activity Can Help Ease Treatment Side Effects

For patients that are getting hormone therapy for their prostate cancer, exercise can help with some of the side effects, some of which can be similar to those that women get during menopause. Some of the potential problems with hormone therapy can be osteoporosis, hot flashes, issues with sexual libido and weight gain. Staying physically active can help minimize these side effects.

Physical Activity Can Improve Your Treatment Options

There are a wide variety of reasons to keep up your fitness level throughout your life, however for prostate cancer patients research suggests that physical activity activates certain genetic pathways in your body, which can help improve how well medicines work.

Try to Keep Your Weight To a Normal Level.

Researchers at Fred Hutchinson Cancer Research Center conducted a study that suggests the risk of dying from prostate cancer is more than double in obese men diagnosed with the disease, compared with men of normal weight. Men that are obese and have cancer that is limited to a specific area, have nearly four times the risk of their cancer spreading.

Activity Can Help You Beat Fatigue

Cancer treatments can often make patients feel tired. This is due to many factors including anemia, chemotherapy and radiation side effects, depression, and the cancer itself.

People often think that exercising when you are fatigued sounds counterproductive, but it is indeed a good way to combat fatigue. Researchers have proved that people with cancer who exercise regularly have 40%-50% less fatigue than those who don’t.

Activity Can Be a Mood Booster

Keeping your spirits up is easier when you are physically active. It’s a way to have control over your body in a good way. Exercise for prostate cancer patients can really help make them feel more positive.

What Activity Is Best For You?

Experts say that the ideal exercise/activity plan includes three parts: an activity like a brisk walk to get your heart pumping, strength training such as lifting weights to build muscle, and stretching to keep your muscles and joints limber.

For patients that weren’t physically active before their diagnosis, the advice is to start slowly. Each day just do a little more and a little more. Don’t strain yourself at the start of your new regime or you will just get discouraged. It’s fine to being with a simply 10-minute walk and work your way up slowly to a level such as 30 minutes, 5 days a week.

Your Relationship And The Effects Of Advanced Prostate Cancer

When a patient gets a diagnosis of advanced prostate cancer many things can change. One of those can be their relationship with their partner. There are ways to respond to this situation that can be helpful to the relationship.

What Can You Expect?

The statement “Knowledge is power” can be very apropos in this kind of circumstance. Understanding the physical and sexual side effects that could occur during or after prostate cancer treatment, will help couples be better prepared to handle them.

Your doctor can help you understand the symptoms a patient might experience and how to best manage them. It’s important that both partners understand this information.

It is very common for men who go through prostate cancer treatment have trouble getting or maintaining an erection in the first few months after treatment. On occasion these problems can be long-lasting.

Strong medicine is used in advanced prostate cancer including radiation, chemotherapy, surgery, and medications (including hormone therapy). Their side effects can include weight gain, lower libidos, fatigue and urinary incontinence. The side effects can be very upsetting to patients but there are many ways to help manage them.

Some men for example who experience erectile problems after treatments may be able to get erections with the help of medications, injections, or surgeries (such as penile implants).

Extra Affection Can Help

At a stressful time like this it’s important to focus on your relationship as a couple. Kisses and hugs and physical touch are good ways to keep the feeling of being connected. Even extra eye contact can help couples feel more in touch with each other.

Intimacy Can Come in Many Forms

During and after treatments sex may have to take a backseat and that’s to be expected. There are many ways to be sexual and couples just have to be open to new ways of looking at this issue.

There Are Pros Who Can Help

A couple’s therapist can help you and your partner if you are having trouble with sexual or emotional closeness when you’re dealing with cancer. Many men are reluctant to see a therapist, but it can be an important part of the whole treatment process/plan.

Keep The Faith It Will Get Better

Even you and your partner struggle with your relationship at times, patients need to realize that in the majority of cases it does get better and their relationship with their spouse does not have to deteriorate. In fact, when asked after treatment is finished, many couples say that dealing with prostate cancer has made their relationship stronger than ever.