Prostate Cancer…….Prostate Cancer…….

Facts Every Man ShouldFacts Every Man Should

Know!Know!

What is the Prostate Gland?What is the Prostate Gland? The prostate gland is part of the male The prostate gland is part of the male

reproductive system that makes the fluid that reproductive system that makes the fluid that carries sperm.carries sperm.

It is a walnut size gland that only men have.It is a walnut size gland that only men have. The gland is located in front of the rectum and The gland is located in front of the rectum and

below the bladder. The urethra (the tube that below the bladder. The urethra (the tube that carries urine from the bladder to exit the body) carries urine from the bladder to exit the body) runs through the center of the prostate. As men runs through the center of the prostate. As men age, the prostate tends to increase in size. This age, the prostate tends to increase in size. This can cause the urethra to narrow and decrease can cause the urethra to narrow and decrease urine flow.urine flow.

The Prostate GlandThe Prostate Gland

How Significant is Prostate Cancer

Source: CDC Cancer Control Initiatives Website

Over 232,000 men are diagnosed with prostate cancer annually, and approximately 30,000 men will die from the disease each year.Source: ACS 2005 Facts & Figures

Prostate cancer is the most diagnosed cancer in Prostate cancer is the most diagnosed cancer in American men and the second leading cause of American men and the second leading cause of cancer death.cancer death.

Prostate cancer strikes as many men as breast Prostate cancer strikes as many men as breast cancer does women, but lacks the national cancer does women, but lacks the national awareness and research funding breast cancer awareness and research funding breast cancer currently receive.currently receive.

The 5-year survival rate for patients whose The 5-year survival rate for patients whose cancer is caught while still confined to the cancer is caught while still confined to the prostate is 99% while the 5-year survival rate for prostate is 99% while the 5-year survival rate for those diagnosed with advanced disease is 30.9%.those diagnosed with advanced disease is 30.9%.

Source: National Cancer Institute’s SEER (Surveillance, Epidemiology, and End-Results) ProgramSource: National Cancer Institute’s SEER (Surveillance, Epidemiology, and End-Results) Program

Who is at Risk for Prostate CancerWho is at Risk for Prostate Cancer

FAMILY HISTORYFAMILY HISTORY - Men with a father, - Men with a father, brother, or son who has had prostate brother, or son who has had prostate cancer are at greater risk for developing it cancer are at greater risk for developing it themselvesthemselves

RACERACE - Prostate cancer is more common - Prostate cancer is more common in African-American men than in white in African-American men than in white men. It is less common in Hispanics, men. It is less common in Hispanics, Asians, Pacific Islanders, and Native Asians, Pacific Islanders, and Native Americans than in Whites.Americans than in Whites.

While all men are at risk for prostate cancer, some factors increase the risk.

• The preponderance of prostate cancer among The preponderance of prostate cancer among Black males is almost at epidemic levels.Black males is almost at epidemic levels.

• Black men in America are at least 50% more Black men in America are at least 50% more likely to develop prostate cancer than men of likely to develop prostate cancer than men of any other racial or ethnic group in this country.any other racial or ethnic group in this country.

• Roughly 66% of Black men diagnosed with Roughly 66% of Black men diagnosed with prostate cancer survive at least five years prostate cancer survive at least five years compared to 81% of white men with the compared to 81% of white men with the disease. disease.

• Mortality rates among Black prostate cancer Mortality rates among Black prostate cancer victims are twice as high as that for white men, victims are twice as high as that for white men, and this rate is increasing almost 2% per year. and this rate is increasing almost 2% per year. Source: National Cancer Institute’s SEER (Surveillance, Epidemiology, and End-Results) ProgramSource: National Cancer Institute’s SEER (Surveillance, Epidemiology, and End-Results) Program

Incidence And Death Rates by RaceIncidence And Death Rates by Race

Incidence Incidence

per 100,000per 100,000Death Death

per per 100,000100,000

African AmericanAfrican American 272.1272.1 73.073.0

CaucasianCaucasian 164.3164.3 30.230.2

HispanicHispanic 137.2137.2 24.124.1

AsianAsian 100.0100.0 13.913.9

Native AmericanNative American 53.653.6 21.921.9Source: National Cancer Institute’s SEER (Surveillance, Epidemiology, and End-Results) Program

What is Prostate CancerWhat is Prostate Cancer

Cancer is a cellular disease.Cancer is a cellular disease.

It is a disordered and abnormal cell It is a disordered and abnormal cell growth.growth.

In prostate cancer, as in other types In prostate cancer, as in other types of cancer, cells grow out of control of cancer, cells grow out of control and form tumors.and form tumors.

If the tumor is within the gland, the cancer If the tumor is within the gland, the cancer is said to be localized and curable.is said to be localized and curable.

If the cancer escapes the gland it is If the cancer escapes the gland it is considered incurable.considered incurable.

Early detection before the cancer escapes Early detection before the cancer escapes the gland becomes very important.the gland becomes very important.

EARLY detection

and

EFFECTIVE treatment

when the cancer

is localized

can save your life!

What Are The Symptoms Of What Are The Symptoms Of Prostate CancerProstate Cancer

Unfortunately, prostate cancer can progress Unfortunately, prostate cancer can progress without symptoms or show symptoms that occur without symptoms or show symptoms that occur with other conditions – as a result, many men with other conditions – as a result, many men with prostate cancer never know it until it is too with prostate cancer never know it until it is too late!late!

Major symptoms are: urinary frequency, slow Major symptoms are: urinary frequency, slow urinary flow, painful urination, blood in urine or urinary flow, painful urination, blood in urine or semen, back or thigh pain and impotence.semen, back or thigh pain and impotence.

Because these symptoms can be caused by other Because these symptoms can be caused by other conditions, testing for prostate cancer with PSA conditions, testing for prostate cancer with PSA and DRE becomes fundamentally important to and DRE becomes fundamentally important to avoid an advanced stage diagnosis.avoid an advanced stage diagnosis.

What You Should Know About The What You Should Know About The PSAPSA And And DREDRE Tests Tests

Medical opinion is divided on use of the PSA. (Us Medical opinion is divided on use of the PSA. (Us Too recommends PSA and DRE annually)Too recommends PSA and DRE annually)

PSA is not prostate cancer-specific.PSA is not prostate cancer-specific. One test out of range may have various causes. One test out of range may have various causes. The real value of the PSA test is in serialization: The real value of the PSA test is in serialization:

Testing year to year and observing the rate of Testing year to year and observing the rate of change.change.

An exponential variation in PSA has been An exponential variation in PSA has been documented to represent tumor growth 7 to 9 documented to represent tumor growth 7 to 9 years prior to a diagnosis of prostate cancer.years prior to a diagnosis of prostate cancer.

What is PSA (Prostate Specific What is PSA (Prostate Specific Antigen)Antigen)

PSA is a protein secreted by both normal and PSA is a protein secreted by both normal and malignant prostate cells.malignant prostate cells.

PSA is measured by a simple blood test sent to a PSA is measured by a simple blood test sent to a lab – results are usually returned within 24 to 48 lab – results are usually returned within 24 to 48 hours. hours.

When tested for prostate cancer, ask your doctor When tested for prostate cancer, ask your doctor for a copy of your results. Normal PSA range is for a copy of your results. Normal PSA range is based on age. based on age.

Serial PSA can detect sudden changes in year-to-Serial PSA can detect sudden changes in year-to-year measurement value that need to be year measurement value that need to be investigated.investigated.

Sudden PSA changes can be caused by infection, Sudden PSA changes can be caused by infection, irritation, Benign Prostate Hyperplasia (BPH) or irritation, Benign Prostate Hyperplasia (BPH) or prostate cancer. Infection needs to be ruled out. prostate cancer. Infection needs to be ruled out.

Age-adjusted Normal PSA RangeAge-adjusted Normal PSA Range

Age (yr)Age (yr) Normal Range (ng/ml)Normal Range (ng/ml)

40-4940-49 0-2.5 (0-2.0 for African 0-2.5 (0-2.0 for African Americans)Americans)

50-5950-59 0-3.50-3.5

60-6960-69 0-4.50-4.5

70-7970-79 0-6.50-6.5Source: Mayo Clinic

What is DRE (Digital Rectal What is DRE (Digital Rectal Examination)Examination)

Your doctor will examine your prostate Your doctor will examine your prostate gland for irregularities by feeling the gland gland for irregularities by feeling the gland through the rectum. DRE takes only a few through the rectum. DRE takes only a few seconds to perform. seconds to perform.

DRE is an important evaluation that DRE is an important evaluation that enhances the value of PSA testing in early enhances the value of PSA testing in early disease detection.disease detection.

DRE and PSA are complementary and DRE and PSA are complementary and together are able to detect prostate together are able to detect prostate cancer when individually they might not.cancer when individually they might not.

Us TOO International and all of its Us TOO International and all of its affiliates recommend:affiliates recommend:

• Men at higher risk (African American Men at higher risk (African American men 40 years and older) should begin men 40 years and older) should begin testing annually with both a PSA and testing annually with both a PSA and DRE. DRE.

• Caucasian, Hispanic and Native Caucasian, Hispanic and Native American men should be tested American men should be tested annually beginning by age 50. If your annually beginning by age 50. If your doctor does not suggest it, you should doctor does not suggest it, you should request it.request it.

When Should I have my PSA Test When Should I have my PSA Test and Digital Rectal Examsand Digital Rectal Exams

African American menAfrican American men, as well as men with family history , as well as men with family history of prostate cancer, should have PSA testes and digital rectal of prostate cancer, should have PSA testes and digital rectal exams annually beginning at age 40. exams annually beginning at age 40.

PSA tests and DREPSA tests and DRE should be performed every year for should be performed every year for men beginning at age 50 according to Us Too International men beginning at age 50 according to Us Too International guidelines. guidelines.

Some physicians may not offer annual PSA and DRE to Some physicians may not offer annual PSA and DRE to

men at risk. Men should men at risk. Men should demanddemand the test! Remember the test! Remember it is YOUR HEALTH you are dealing with. it is YOUR HEALTH you are dealing with.

What if My PSA Test Results Came What if My PSA Test Results Came Back Above NormalBack Above Normal

Learn more about your treatment options Learn more about your treatment options by contacting your doctor. by contacting your doctor.

Your doctor may order a biopsy; a small Your doctor may order a biopsy; a small sample of prostate tissue is removed with sample of prostate tissue is removed with a needle and examined under a a needle and examined under a microscope.microscope.

Get a second opinion on the biopsy sample Get a second opinion on the biopsy sample by a pathologist specializing in prostrate by a pathologist specializing in prostrate cancer, and from an unbiased specialist in cancer, and from an unbiased specialist in prostate cancer treatment.prostate cancer treatment.

Other reasons your test results may Other reasons your test results may be high are: 1) Benign Prostrate be high are: 1) Benign Prostrate Hyperplasia (BPH) a non-cancerous Hyperplasia (BPH) a non-cancerous condition that shares some condition that shares some symptoms of prostate cancer, and symptoms of prostate cancer, and 2) BPH causes the prostate to get 2) BPH causes the prostate to get bigger and can place pressure on bigger and can place pressure on the urethra, the tube that carries the urethra, the tube that carries urine, resulting in urinary problems. urine, resulting in urinary problems.

Four ways to Avoid Advanced Four ways to Avoid Advanced Stage DiagnosisStage Diagnosis

1.1. Men assuming responsibility for their Men assuming responsibility for their health.health.

2.2. Early Detection.Early Detection.

3.3. Early DetectionEarly Detection

4.4. Early DetectionEarly Detection

And

How is Prostate Cancer DiagnosedHow is Prostate Cancer Diagnosed

If either the PSA and DRE are abnormal a biopsy If either the PSA and DRE are abnormal a biopsy may be done. (Transrectal ultrasound guided may be done. (Transrectal ultrasound guided biopsy) The procedure is relatively simple, just biopsy) The procedure is relatively simple, just like the DRE. like the DRE.

The ultrasound uses sound waves to detect signs The ultrasound uses sound waves to detect signs of cancer on the prostate gland. Then a tiny of cancer on the prostate gland. Then a tiny needle is used to take a biopsy; very small needle is used to take a biopsy; very small samples of tissue from at least six different areas samples of tissue from at least six different areas of the prostate.of the prostate.

The samples are sent to a medical laboratory for The samples are sent to a medical laboratory for evaluation by a pathologist and the results are evaluation by a pathologist and the results are normally back within a few days.normally back within a few days.

IN CASE OF A POSITIVE IN CASE OF A POSITIVE BIOPSYBIOPSY

DO NOT PANICDO NOT PANIC LEARN MORE ABOUT YOUR LEARN MORE ABOUT YOUR

TREATMENT OPTIONS BY TREATMENT OPTIONS BY CONTACTING YOUR DOCTORCONTACTING YOUR DOCTOR

Types of Treatment ProceduresTypes of Treatment Procedures

Watchful WaitingWatchful Waiting – Monitoring the patient’s prostate – Monitoring the patient’s prostate cancer by performing PSA test and Digital Rectal Exam cancer by performing PSA test and Digital Rectal Exam regularly, and treating it only if and when the prostate regularly, and treating it only if and when the prostate cancer causes symptoms or show signs of growing.cancer causes symptoms or show signs of growing.

Radical ProstatectomyRadical Prostatectomy – Removal of the entire prostate – Removal of the entire prostate gland and nerves.gland and nerves.

External Radiation TherapyExternal Radiation Therapy – High-energy rays to kill or – High-energy rays to kill or shrink cancer cells.shrink cancer cells.

When prostate cancer has been found in its early stages and has not spread beyond the prostate, a doctor and his/her patient may decide upon various treatment options; each has its own risks and benefits.

CryosurgeryCryosurgery – Freezes abnormal cells of the – Freezes abnormal cells of the prostate with a metal probe.prostate with a metal probe.

Hormone TherapyHormone Therapy – Decreases the androgen – Decreases the androgen (testosterone) levels in the body by giving certain (testosterone) levels in the body by giving certain hormones to keep prostate cancer from growing.hormones to keep prostate cancer from growing.

ChemotherapyChemotherapy – Anticancer drugs injected into – Anticancer drugs injected into the vein or taken by mouth.the vein or taken by mouth.

Transurethral Resection of the prostateTransurethral Resection of the prostate (Brach Therapy) – Confined dosage of radioactive (Brach Therapy) – Confined dosage of radioactive seeds inserted directly into the prostate while seeds inserted directly into the prostate while minimizing healthy tissue damage.minimizing healthy tissue damage.

Side Effects of TreatmentSide Effects of Treatment Side effects may depend on:Side effects may depend on:

• The type of treatmentThe type of treatment• Patient age, and Patient age, and • Overall healthOverall health

Person could experience pain, discomfort, and Person could experience pain, discomfort, and other mild to severe side effects such as:other mild to severe side effects such as:• Impotence, the inability to attain and maintain an Impotence, the inability to attain and maintain an

erection hard enough to complete sexual intercourse erection hard enough to complete sexual intercourse more than half the time sex is desired.more than half the time sex is desired.

• Incontinence, loss of bladder control or dribbling.Incontinence, loss of bladder control or dribbling.• Bowel problem, burning and rectal pain and/or diarrhea.Bowel problem, burning and rectal pain and/or diarrhea.

Ask a doctor about side effects. He/she may be Ask a doctor about side effects. He/she may be able to prescribe something to relieve them.able to prescribe something to relieve them.

Making the Choice to Know Your Score!Making the Choice to Know Your Score!

Meet with your physician and discuss your questions and concerns. Make a joint decision with your physician and family.

Remember: The earlier prostate cancer is discovered, the better the chances are that it can be treated effectively.

Make the choice to KNOW YOUR SCORE!