Prostate Cancer Screening: Part 2 with Dr. Stephen Taylor in Walnut Creek

Men with both normal & elevated PSA levels often have a number of good-health alternatives

In a previous blog posting, I discussed the reasons for men to continue routine PSA tests as part of their annual physical exams.

Earlier this year the U.S. Preventive Services Task Force issued a recommendation against prostate-specific antigen screening for men. I believe this to be bad advice. based on my review of many other scientific articles and attendance at many Urologic Oncology meetings.

In my 30 years experience in urology, I have treated thousands of men with prostate problems. In the pre-PSA screening era, only 10 percent of prostate cancers were discovered at curable stages.

Since PSA screening became routine, 90 percent of prostate cancers are now discovered at potentially curable stages.

Few advances in medicine have brought such a dramatic improvement – your chances of early detection are nine times better than before the PSA test was available.

Just as importantly, you should know that not all prostate cancers require active treatment. Further, many are not life threatening.

One of the reasons the USPSTF gives for its recommendation is that too many PSA tests lead to unnecessary and harmful biopsies and surgeries. They’re missing an important point: one PSA test does not necessary lead to either.

If a single screening reveals a high PSA level, he and his doctor have to consider a wide variety of factors such as the patient's age and other health conditions. These include the presence or absence of urinary symptoms, size of the prostate, texture of the prostate, and the presence or absence of a nodule.

Surgery or even biopsy is not necessarily the next step – sometimes a second test is a good option. Often men may wisely choose to engage in what’s called active surveillance:  a process of simply monitoring the PSA level over months or years to see if more aggressive action is merited.

Most men are lucky enough to have had years of normal PSA levels. If you’re one of those, don’t just count yourself lucky. Take action to help ensure your continued good health. Here are simple steps to safeguard against prostate cancer.

Five Steps to Preventing Prostate Cancer:

1. Test Annually

Men should undergo annual prostate specific antigen (PSA) blood test screenings and digital rectal exams (DRE) starting at age 50 or earlier. High  risk patients such as African American men and men with a first degree relative diagnosed with prostate cancer at a younger age should begin testing at age 45.

1. Listen to Your Body

If you notice unexpected changes in your health, be diligent in addressing them. A change in the frequency, urgency and pressure during urination, painful urination or the presence of blood in urine is a warning sign. Painful ejaculation, blood in the semen and erectile dysfunction as well as bone pain and pelvic discomfort are additional warning signs.

1. Diet & Alcohol Intake

Eat healthy, balanced meals rich in fruits, vegetables and whole grains. Some studies show that eating foods rich in omega-3 fatty acids (such as salmon and mackerel), soy products, legumes, drinking green tea and getting Vitamin D in your diet may reduce cancer risk. Limit yourself to no more than two drinks per day as studies show that regular heavy drinking increases prostate cancer risk.

1. Maintain a Healthy Weight

Quite simply, a healthy body can fight disease. While a direct link between obesity and prostate cancer has not been established, obesity may affect hormone levels related to prostate cancer risk as well as increase the risk of dying from prostate cancer.

1. Exercise

Regular exercise keeps your body healthy and in shape. I recommended at least 30 minutes of aerobic exercise three to seven times per week.

For more information on prostate cancer, visit the Pacific Urology website. 

Dr. Stephen Taylor, Pacific Urology of Walnut Creek