Surviving Prostate Cancer: Why Early Detection Can Be Importantby James Hubbard, MD, MPH

Sometimes people forget that not only prevention but early detection of serious illness is one of the best survival techniques. I recently thought of this when reading up on a few of the latest recommendations for prostate cancer, the leading cause of cancer in men.

Men over 50 are especially prone to this cancer, although it’s not that unusual for it to occur in our 40s. The thing is, there are no symptoms unless the cancer is really advanced. (Trouble urinating is much more likely just an enlarged prostate, which is not known as a risk factor for cancer.) Prostate cancer can only be detected if a lump is felt during a digital exam (the dreaded finger) or by a blood test called a PSA. Then you need a biopsy to confirm.

But if prostate cancer is detected, what do you do? Fortunately there are number of treatments that have good cure rates—surgery, radiation, radiation pellets, and hormone therapy. Unfortunately they all come with frequent side effects, such as fecal incontinence, urinary incontinence, and impotence. Yeah, there’s Viagra, and you can live with the other side effects, however uncomfortable. But there is another option for some. It’s called active surveillance or watchful waiting.

Prostate Cancer Treatment and Detection

The majority of prostate cancer cases are very slow growing. The disease can take decades to spread beyond the prostate and become potentially lethal. So, in some cases of prostate cancer, you can opt to do nothing except have regular checkups, blood tests, and periodic biopsies. If it the cancer starts getting worse, then you can start active treatment. Sometimes you may never need it (usually because you die of something else—bummer). Or, maybe the treatments will improve in time.

Anyway, because most prostate cancers are slow growing, there is confusion even among experts about when and how often to get tested. I mean, if you’re not going to be treated, why be tested? The problem with that thinking is that some prostate cancer types are a much faster-growing type, and early treatment of those could be life-saving. So what’s a feller to do?

Well, for me, I’m going to continue to get tested every year or two. If cancer is found, other tests can be done to see if odds are it’s the fast-growing type. By the way, an interesting fact I didn’t know until reading lately is that most prostate cancer found in people in their 50s or early 60s is the slow-growing type. The older you are, the greater the odds it’s the faster-growing.

If I were to have the fast-growing type, I’d start treatment. If odds were really good it was slow growing, I’d bide my time a bit more. Another thing that would help me decide is, after the biopsy, the PSA, and maybe an ultrasound or MRI, doctors can add up the scores and make an even better prediction on how soon the cancer is likely to spread. If my score were in the low-risk category, I’d probably do the “active surveillance” option. If it weren’t, I’d go with treatment. I won’t get into treatment options. They’re a whole other post.

You may be asking, what does that have to do with disaster prep? Well if, perchance, you were pretty sure there was going to be a very long-term—maybe permanent—collapse of society, you might consider getting treatment earlier since you’d have a good chance of cure while treatment was still around.

Prostate Cancer Prevention

As I said in the beginning though, the best prep would be to decrease your risk of getting prostate cancer in the first place.

Studies are being done on the effectiveness of supplements. So far, selenium hasn’t been shown to help. And vitamin E was actually shown to slightly increase the risk of prostate cancer. Soy products are still in the running, and aspirin looks to help a little. (Don’t take if you have bleeding issues or are on a blood-thinning drug such as warfarin.)

Things that have been proven to decrease risk the most so far are the same old boring eat vegetables, go light on red meat, exercise, and don’t get fat. (Why can’t they discover that sitting and blogging all day is good for you?)

Anyway, have you had experience with prostate cancer treatments? How’s it going?