Prostate cancer is a sneaky disease. By the time you develop symptoms, it’s already begun to spread. That’s why the American Urological Association recommends regular screenings for men starting at age 55. Those at high risk, such as African-American men or men with a family history of prostate cancer, should be screened even earlier, starting at age 45.
According to Murugesan Manoharan, M.D., Miami Cancer Institute, prostate cancer is asymptomatic and there are only two ways you can test for it. “The first, Prostate Specific Antigen (PSA), measures an enzyme produced by your prostate cells,” says Dr. Manoharan. “Higher PSA levels can be found in the blood as prostate cancer cells begin to proliferate in an uncontrolled way.”
The second is a digital rectal exam performed by your doctor, who feels your prostate for hard, lumpy, or abnormal areas. If a suspicious lump or area is detected, your doctor will recommend further tests to see if it’s prostate cancer or a benign, non-cancerous condition such as an enlarged prostate, prostate inflammation or infection. Both the PSA and digital rectal exams should be performed as part of your annual physical exam.
Doctors worry that, because of the coronavirus, many men are not keeping up with their screenings – partly because preventative screenings were paused for several months at the height of the pandemic but also because some people are avoiding hospitals and doctors’ offices out of concern for their safety.
“The number of prostate cancer screenings and diagnoses at Miami Cancer Institute is down 30 to 40 percent since March,” Dr. Manoharan says. “For high-risk individuals especially, regular screenings are very important, so my advice is to not delay your care because you’re concerned about COVID-19. Miami Cancer Institute goes to extraordinary lengths to ensure the safety of our patients and staff. And we also have in-house COVID-19 testing, which puts us in a different league from other hospitals.”
The good news for men diagnosed early enough, Dr. Manoharan says, is that the five-year survival rate is virtually 100 percent. “If caught early enough, there are numerous treatment options for prostate cancer, including surgery to remove the prostate gland (radical prostatectomy) or precision, laser-guided radiation such as proton therapy.”
New therapies for prostate cancer are also on the horizon, according to Dr. Manoharan. Miami Cancer Institute is currently participating in two different clinical trials, one of which is testing the efficacy of a novel hormone therapy, apalutamide, in combination with radical prostatectomy for treating metastatic prostate cancer in high-risk patients. The other is for the NanoKnife, which is now approved for use to treat prostate cancer. The NanoKnife allows the surgeon to deliver precisely controlled bursts of high-voltage electricity to safely destroy cancerous cells while sparing healthy surrounding tissue.
For National Prostate Cancer Awareness Month in September, Dr. Manoharan recommends getting yourself screened. “It’s such an easy test, and one that could save your life. Please don’t put it off.”
For more information about prostate cancer and the latest advances in radiation treatment, listen to the recent Baptist HealthTalk podcast with Marcio Fagundes, M.D., medical director of radiation oncology at Miami Cancer Institute.