Health Tips

The prostate gland is part of the male reproductive system. It makes and stores semen (ejaculate) and is located near the rectum and beneath the urinary bladder.

Prostate cancer is generally slow growing although there is a percentage of them that are fast growing. As of today we do not have a way to distinguish this.
Most men are over the age of 65 when diagnosed with prostate cancer but with the use of PSA (prostate specific antigen) prostate cancer is being detected earlier and this average age is getting younger and younger.

For the most part there are no symptoms with this cancer until it has spread beyond the prostate. It truly is a silent killer.

How can we diagnose prostate cancer?

There are 2 tests that need to be done on all men 50 years of age or older and for men whose father’s were diagnosed need to start at the age of 40.

1. The first test if the digital rectal exam performed by your doctor and needs to be done annually after 50 yrs old. The doctor is checking to see if you have any unusual masses (lumps) on the prostate as well as checking on the size. As we get older the prostate generally get larger. This is when you may notice that you have to get up at night more often or the urine stream is not as strong as it had been.

2. The next important test is the PSA. This is a blood test that needs should be done annually as well. This test has revolutionized our ability to detect cancer early AND BEFORE it has has spread. The test normal range is usually 0.2 to 4.0. Know your level ask your doctor what your level is. Anything above should be repeated.

3. There is currently a controversy in the medical community about the appropriate level for a normal PSA. There has been a suggestion that we are missing a percentage of cancers with the normal level set at 4.0. The suggestion is that the normal should be lowered to 2.6 instead of 4.0.

4. Another factor that is slowly emerging with the PSA test is the speed of the increase in the levels of the PSA. In other words, we are looking at how fast the results are climbing year after year. For the most part there is generally minimal difference in the test year to year. There is increased specualtion that if the test results are climbing every year this may become an indication to get a biopsy before the magic result number of 4.0

How should you react when you get a level over 4.0?
Well you need to talk with your doctor about what his/her suggestion and thoughts are. Some physicians will look at the speed of change in the numbers and suggest a prostate biopsy. Maybe he/she feels that there may be a mild infection in the prostate that can cause sn elevated level. I would strongly suggest that you get the test repeated first over the next month or two.

If it is still above 4.0 you should seriously consider a prostate biopsy. This is a procedure which carries very little pain. I had it and it was not what I feared AT ALL. Be SURE that the pathologist who is reading the biopsy is skilled in reading these under the microscope.

Occasionally due to the small and early nature of this cancer the biopsy misses the cancer tissue. It will be important to follow the PSA closely with your doctor.

There has been considerable discussion about the herbal plant called saw palmetto. This has been studied and there is some evidence that it does help to diminish prostate problems, especially prostate enlargement. Saw palmetto is widely used in other countries; for example, it is used in 50 percent of treatments for BPH in Italy and in 90 percent of such treatments in Germany.

So, my recommendation is for all men over 50 to get the PSA blood test and watch the levels, if they rise fast or become over the level of 4.0 have a serious discussion with your doctor on what the next step should be. If you are not satisfied by all means get another opinion.

There are 2 books on the Prostate that I would recommend to you. Dr Bob Arnot’s book on Prostate Health to help avoid the prostate diseases and Dr Nixon’s which is a thorough discussion and well worth it:

The Prostate Health Program: A Guide to Preventing and Controlling Prostate Cancer

The Prostate Cancer Protection Plan : The Foods, Supplements, and Drugs that Can Combat Prostate Cancer