Clark Howard’s diagnosis highlights prostate cancer

Many men sympathized with Clark Howard when he revealed that he has prostate cancer. Likewise, the radio host sympathized with them for not getting screened.

Sixty percent of men age 50 and over have been screened for prostate cancer, but typically only once in five years, according to Zero, a prostate cancer advocacy group formerly known as the Prostate Cancer Coalition. Howard and organizations such as Zero promote routine screening as key to early detection and saving lives.

During 2008, about 186,320 new cases of prostate cancer were diagnosed in the United States, according to the American Cancer Society. About one in six men will be diagnosed with prostate cancer during their lifetime, but only one in 35 will die from it.

Prostate cancer screening has become the subject of debates, discussions and new clinical trials because screening has not been shown to save lives, researchers claim.

According to Otis Brawley, chief medical officer of the American Cancer Society, no medical organization in the United States that has researched the data on prostate cancer screening recommends that men get screened.

“We are for informed decision making,” Brawley said. “Our recommendation is not that men should be screened, but that they should be offered the test, informed of the potential risk and benefits, and encouraged to make a choice whether to get the test.”

Specifically, the Cancer Society recommends that doctors discuss screening with men beginning at age 50, and men at high risk. This latter group includes African-American men and men with a strong family history of one or more relatives diagnosed at an early age. Initial discussion for that group is recommended at age 45.

The Cancer Society also encourages men to begin discussing a prostate health plan with their doctors when they turn 40.

Screening occurs in two ways:

> A test in which blood is drawn from the arm to measure prostate-specific antigen, or PSA.

> A digital rectal exam involves the physical examination of the prostate for irregularities in size, shape and texture. This exam often helps distinguish between prostate cancer and non-cancerous conditions.

Prostate cancer screening is not like a pregnancy test; it doesn’t say ‘yes’ or ‘no,’ doctors caution, noting that an elevated PSA could signal just an infection of the prostate or an enlarged prostate. It gives you a snapshot but not a really good, complete picture.

PROSTATE CANCER STATISTICS

> Prostate cancer is the most common cancer, other than skin cancers, in American men.

> About 1 man in 6 will be diagnosed with prostate cancer during his lifetime, but only 1 man in 35 will die of it.

> More than 2 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today.

> Prostate cancer is the second leading cause of cancer death in American men, behind only lung cancer.

> The American Cancer Society estimates that 28,660 men in the United States died of prostate cancer in 2008.

> Prostate cancer accounts for about 10 percent of cancer-related deaths in men.

Source: American Cancer Society

Questions to ask if you’ve been diagnosed:

> What are the chances that the cancer has spread beyond my prostate? If so, is it still curable?

> What further tests, if any, do you recommend, and why?

> What is the clinical stage and Gleason score, or grade, of my cancer? What do those mean in my case?

> What is my expected survival rate based on clinical stage, grade and various treatment options?

> Should I consider watchful waiting as an option? Why or why not?

> Do you recommend a radical prostatectomy or radiation? Why or why not? > If you recommend radical prostatectomy, will it be nerve sparing?

> Should I consider laparoscopic or robot-assisted prostatectomy?

> What types of radiation therapy might work best for me?

> What other treatments might be right for me? Why?

> Among those treatments, what are the risks or side effects that I should expect?

> What are the chances that I will have problems with incontinence or impotence?

> What are the chances that I will have other urinary or rectal problems?

> What are the chances of recurrence of my cancer with the treatment programs we have discussed? What would be our next step if this happened?

> Should I follow a special diet?

Source: American Cancer Society