Men should not ignore signs, symptoms of prostate cancer: Linda Rhodes

on September 17, 2013 at 10:06 PM, updated September 17, 2013 at 11:11 PM

Q: My dad recently was diagnosed with prostate cancer and we’re trying to make sense of all the different options for him to consider. Can you give us the basics?

A: Over the past few years there has been a great deal of debate and confusion over when to screen for prostate cancer and how to treat it, if at all. Recent research findings show 25 different kinds of prostate cancer while common myths surrounding the disease continue to grow. It’s no wonder we’re all a bit dazed.

But before we tackle your question, let’s get a few of those myths out of the way: First,

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it’s not just an old gent’s disease. Yes, older men are at higher risk and 65 percent of prostate cancer cases are among men over 65 years of age, but that means one-third are younger. In fact, 1 in 38 men ages 40-59 will be diagnosed with prostate cancer this year. Second, just because it can be a slow-growing cancer, doesn’t mean it’s slow in all cases. Prostate cancer can be of the aggressive, fast-growing type and can only be determined by a biopsy. Third, the absence of symptoms doesn’t mean you’re in the clear. It’s one of the stealthiest cancers out there. For many men, the first sign of prostate cancer is discovered during a routine exam by their family doctor.

In terms of numbers, 1 out of 6 American men are diagnosed with prostate cancer accounting for more than 250,000 of whom 28,000 will die, as a result. Prostate cancer is the second most dominant form of cancer, after melanoma, in men. African-American males are at greatest risk of the disease as they are 1.6 times more likely to be diagnosed with prostate cancer than Caucasian men and are 2.4 times more apt to die from this disease. A family history of prostate or breast cancer with the BRCA1 or BRCA2 gene and obesity place you at greater risk for prostate cancer.

Take a moment to listen to Lawrence McRae talking to African-American men about the importance of prostate exams.

Now that your dad has joined the ranks of men with prostate cancer, let’s get him among the survivors. He’ll want to ask his doctor, what is the grade of his cancer? The more his cancer cells differ from healthy cells, then the more aggressive his cancer and its ability to rapidly spread. 

A “Gleason Score” is used to grade how aggressive the cancer is: the scoring combines two numbers and ranges from 2 (non-aggressive) to 10 (very aggressive). After determining the grade of cancer, his physician will likely order tests to determine the stage of his cancer which assesses whether or not the cancer has spread outside of the prostate and to what extent. Staging levels are I–IV with IV indicating that the cancer has invaded nearby organs (e.g. bladder) or lymph nodes, bones, lungs or other organs.

Once your dad is given this information, his physician and oncologist will discuss a range of treatment options. Here is a quick run down on what might be offered depending upon the grade and staging of his cancer:

Active surveillance. Your doctor might advise you to wait things out by keeping a close watch with regular blood tests, prostate exams, scans and potential biopsies. This might be suggested when the cancer is in very early stages, is slow growing and confined to a small area of the prostate.

Radiation therapy. Generates high-powered energy to eradicate cancer cells. This can be done externally with high beams focused on the prostate typically offered five days a week for several weeks. Or radiation is placed inside of your body known as brachytherapy by inserting rice-sized radioactive seeds in the prostate’s tissue that release low doses of radiation over time.

Hormone therapy. Stops your body from producing testosterone which prostate cancer cells rely on to grow. This can be done in three ways: taking medications that prevent the testicles from making testosterone known as LH-RH agonists (e.g. Lupron or Zoladex), prescriptions that block testosterone from reaching cancer cells known as anti-androgens (e.g. Casodex or Nilandron). And finally, surgery to remove the testicles known as “orchiectomy” that reduce testosterone levels and may do so more quickly than medications.

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Surgery. This involves removing the prostate gland, surrounding tissue and a several lymph nodes via a range of procedures from laparoscopic to incisions.

Freezing or heating prostate tissue. Cryosurgery kills cancer cells by using small needles that insert a very cold gas into the cancerous tissue followed by a second gas that heats it. The cycle of freezing and thawing kills the cancer cells. Or ultrasound is used to send powerful sound waves to the prostate that heat the cancer cells causing them to die.

Chemotherapy. Utilizes drugs to destroy rapidly growing cancer cells and is often used when prostate cancer has spread or hormone therapy has not been effective.

Immunotherapy. Taps your own immune cells and genetically engineers them to attack the prostate cancer by injecting them back into your body through a vein.

Throughout your dad’s treatment he should maintain a healthy diet, exercise and lose weight if he is obese. And here’s a fascinating tip for all you guys who love your barbecue grill: Cancer-causing molecules like those found in cigarette smoke are contained in charred meats that gather in the prostate just like cigarette smoke carcinogens collect in the lungs. The mutations they cause can lead to prostate cancer. Use foil and turn the meats over frequently, so they don’t end up charred.

Symptoms of prostate cancer 

A need to urinate frequently or trouble urinating, decreased force in the stream of urine, blood in the urine or semen, general pain in the lower back, hips or thighs, discomfort in the pelvic area, bone pain and erectile dysfunction.

For an excellent guide on “Questions to Ask Your Doctor” from the Prostate Cancer Foundation click here or go to or call 800-757-2873.

Source: Mayo Clinic

Dr. Linda Rhodes is a former Secretary of Aging and author of the national award winning book, "The Essential Guide to Caring for Aging Parents." She can be reached at