7 days ago
Former president's diagnosis pushes prostate cancer discussion center stage
TUPELO – Dr. Benjamin Hinton has no problem recommending men have a PSA blood test annually. The test looks for prostate-specific antigen in the blood.
"It is entirely reasonable," said Hinton, a radiation oncologist with North Mississippi Medical Center Radiation Oncology. "Prostate cancer in the vast majority of men presents with no symptoms until in an advanced stage."
The American Cancer Society offers age recommendations to be considered regarding PSAs:
* Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years
* Age 45 for men at high risk of developing prostate cancer. This includes Black men and men who have a first-degree relative (father or brother) diagnosed with prostate cancer at an early age (younger than age 65).
* Age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age).
An argument against annual PSA tests is that it can render a false positive, which causes anxiety. An elevated PSA may signify cancer, but it doesn't always.
The prostate is a reproductive gland in men that is prone to develop cancer.
Considering the recent diagnosis of former President Joe Biden with Stage 4 prostate cancer, there has been more talk of the cancer and more information proffered. Biden's cancer upon diagnosis, had spread to his bones.
Reports that Biden had not had a PSA since 2014 are disconcerting, especially to oncologists.
"I find that puzzling," Hinton said. "But his diagnosis has brought prostate cancer to the forefront."
Thanks to improved diagnostic tools, the discovery and treatment of prostate cancer has also improved.
"Thirty years ago, doctors treated everyone with high PSA numbers," Hinton said. "In fact, in the '80s and '90s, historically, doctors probably over-treated prostate cancer. Some were treated who didn't need it."
Things have changed.
"With a new diagnosis, there is active surveillance," Hinton said. "There is a watch-and-wait approach… and there are advanced molecular studies that further stratify which cancer needs treatment and which does not."
Active surveillance is a strategy involving regular checkups and tests to track changes in the cancer and intervene with treatment if it progresses.
The type of treatment relies on the stage of the prostate cancer. The more aggressive cancer, obviously, will receive the most aggressive treatment. That may include radiation, hormone therapy, chemotherapy and other treatments.
Prostate cancer kills more men in the U.S. than any other type, Hinton said.
"Normally, men have less interaction with physicians than women," he said. "There are no babies, Pap smears, mammograms, so they likely see doctors much less frequently."
When caught early, the cure rate for prostate cancer is very good — 90-plus percent, Hinton said.
Prostate cancer screening offers early detection which allows earlier treatment. Earlier treatment offers the potential for better outcomes and a higher chance for a cure. Whether the results eventually present peace of mind or a plan of action, the PSA is a crucial part of men's health care.
"And with prostate cancer, you may not know you have it unless you go looking for it," Hinton said.
