Questions & Answers
1. If a man has no symptoms, does that mean he does not have prostate cancer?
No. Prostate cancer can be present without any symptoms at all. In fact, some men do not find out that they have prostate cancer until it is quite advanced because there were no initial symptoms.
2. Is prostate enlargement, which is common in older men, a precursor to prostate cancer?
Enlargement of the prostate is not a precursor or risk factor for prostate cancer.
3. How does the digital rectal exam help detect prostate cancer?
A digital rectal exam (DRE) can detect prostate nodules that may be cancerous. If the exam reveals nothing, it’s still possible that a growth may be located on a part of the prostate that the doctor can’t reach. That is why the DRE should be done in conjunction with the prostate-specific antigen test, which can also detect prostate cancer.
4. Is an elevated prostate-specific antigen (PSA) level always an indication of prostate cancer?
The prostate-specific antigen blood test is a screening test that measures the amount of a chemical produced in the prostate called prostate-specific antigen. PSA levels normally increase as a man ages, but a higher-than-normal PSA level can mean that cancer has developed in the prostate gland. However, high levels of PSA also can be found in other conditions that are noncancerous, including prostatitis (inflammation of the prostate) and benign prostatic hyperplasia, or enlargement of the prostate, that affects many older men.
5. What role can wives play in ensuring compliance with prostate cancer screenings of their spouses?
Wives and partners should encourage their spouses/partners to schedule regular annual routine physical exams with their physicians to increase adherence with prostate cancer screenings.
6. Is prostate cancer curable?
Yes. Prostate cancer is most easily — and successfully — treated when it’s still “localized,” meaning it has not yet spread outside the prostate gland. Survival rates of prostate cancer decrease if the cancer has spread to the lymph nodes, bones or other parts of the body.
7. Why is there controversy surrounding screening for prostate cancer?
The number of new cases of prostate cancer has increased over the years; however, fewer men are dying of prostate cancer, even in regions of the U.S. or in other countries where there is very little screening. So, deaths from prostate cancer are decreasing equally in areas or regions where there is a lot of screening and in areas where there is very little screening. In addition, prostate cancer can occur in an aggressive form, which we can cure early with surgery or radiation. These treatments can have serious side effects. It can also occur in a milder, slow-advancing form that rarely causes harm and we often just watch it over time. We don’t yet know how to distinguish between the two forms of prostate cancer when it is detected early. Thus, we cannot identify at an early stage if it is the harmless form that does not require treatment or the aggressive form that would respond to the treatment.
8. Why is the death rate from prostate cancer so much higher in blacks than whites?
African American men have higher rates of prostate cancer and may be less likely to see a physician or receive treatment. As a result, they are more likely to die of this disease. When they do receive adequate treatment, African American men with prostate cancer appear to live as long as white men who are similarly treated.
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Lisa Michelle Owens, M.D.
Medical Director
Brigham Primary Physicians at
Faulkner Hospital
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