Connect
After skin cancer, prostate cancer is the most common type of cancer in men. One in 8 men will be diagnosed with prostate cancer in his lifetime, according to the National Cancer Institute.
While some types of prostate cancer grow slowly, and may need minimal or even no treatment, other types are aggressive and can spread quickly.
So if you’ve been diagnosed with prostate cancer. Now what?
"It's very important to know the extent or stage of the cancer," says Dr. R. Jeffrey Karnes, a Mayo Clinic urologist and chair of the Division of Community Urology at Mayo Clinic in Rochester, Minnesota.
Diagnosis and staging are done using tests, including ultrasound, MRI and biopsy.
Prostate cancer that's detected early — when it's still confined to the prostate gland — has the best chance for successful treatment. Prostate cancer treatment options depend on several factors, such as how fast the cancer is growing, whether it has spread, as well as the potential benefits or side effects of the treatment.
On the Mayo Clinic Q&A podcast, Dr. Karnes discusses treatment options for prostate cancer and the latest in clinical trials and research.
To practice safe social distancing during the COVID-19 pandemic, this interview was conducted using video conferencing. The sound and video quality are representative of the technology used. For the safety of its patients, staff and visitors, Mayo Clinic has strict masking policies in place. Anyone shown without a mask was recorded prior to COVID-19 or recorded in an area not designated for patient care, where social distancing and other safety protocols were followed.
For more information and all your COVID-19 coverage, go to the Mayo Clinic News Network and mayoclinic.org.
Connect with others talking about prostate cancer, and supporting one another in the Prostate Cancer support group.
Like
Helpful
Hug
Connect
If prostate cancer is so prevalent why did doctors quit doing prostate exams and PSA tests? Is this a medicare issue?
I have to ask for them for my annual wellness exam! My father-in-law died from undiagnosed prostate cancer which was only discovered after it had spread to other organs. He had annual exams!
@mazeppabob Wow! The PSA test has been a regular test with my physician. Sounds like your father in law could have used a different doctor.
Tony in Michigan
@tonyinm From your photo, you look like a young man, I am 77. After my fatherr-in-law passed I asked my primary care DR why no prostate exams and PSA tests. The extent of a medicare wellness exam is driven by medicare and I suspect maybe the insurance industry. He made it sound like there are too many false and misleading readings. The risks associated with doing a biopsy of the prostate are quite high.
I definitely want to know if there is something going on there. At my age, I would probably have it removed before cancer could spread. I request the tests.
Hi Bob -
My primary described the Medicare "physical" as a hands-off wellness check. I have to schedule an actual physical to get complete exam. My husband has the annual prostate exam & PSA during one of his 4x a year diabetes check-ins.
If I was in Texas right now, I would poll the guys at Saturday morning coffee...hmm, I wonder how many would answer? FWIW, Medicare is great for some things like managing chronic conditions - asthma, diabetes and blood pressure - not so good for others like routine cancer screenings.
Sue
@mazeppabob My understanding is that the PSA blood test is a crude measure for prostate cancer. The Digital Rectal Exam (DRE) is a better test for the cancer. The doctor feels for abnormalities or areas of hardness. My PSA was increasing with each annual exam so I was referred to a urologist. My PSA increased to 8.6 when I went back to the urologist. I had an ultrasound but that did not indicate a problem so I'm good until next year. The last PSA was 6. something. I've been taking Saw Palmetto on a daily basis. I'm actually looking forward to the next PSA to see if it has gone down even further.
Tony in Michigan
@mazeppabob Good afternoon. I am trying to recall the "discovery process" that my life partner, Jay went through at 70. How much information did the PSA test reveal? Enough to want to schedule a prostate biopsy which was done locally and revealed areas of concern. He chose to seek additional analysis and information from Mayo Clinic. That process was quite thorough and an MRI was used to determine if the cancer was contained in the prostate or had spread to other areas. At that time options were presented, one of which was chosen by Jay and that was surgery. He had to factor in the genetic reality that both his father and grandfather had prostate cancer.
Once the decision for surgery was made for much the same reasons as you outlined, he was included in a shared decision-making process as to how to proceed. He chose to reduce the testosterone with Lutron prior to surgery to hopefully ensure that the spread would be contained. After surgery and recovery, everything stayed positive for a couple of years only to reappear as his PSA climbed.
Further tests indicated that a small section of the cancerous tissue was accidentally dropped in the prostate bed. They chose photo beam therapy....30 days of it.....to remove the affected tissue. That was almost three years ago and he has had intractable PSA scores since that time. Early on, he went for a complete check-up every six months. Then it was extended to a year. And now....he doesn't have to return to Mayo for 2 years......just sends in his PSA scores every 3 months.
Hopefully, this recounting of another way to do things......will be helpful.
Do you have a genetic history of prostate cancer in your family?
May you be safe and protected from inner and outer harm.
Chris
My current urologist is in the camp of tracking PSA, taking ultrasounds and MRI over digital exam (and will only do biopsy when the MRI shows there's something to check into). His logic is that the digital exam detects only a fraction of one side of the prostate so lesions "hiding" out of the range of detection are completely invisible. (I can attest to the validity of his position because my father had BPH and high PSA and his doctor regularly performed digital exams which revealed NOTHING. Unfortunately, prostate cancer wasn't detected until it had metastasized and was discovered as a skin lesion.)
As far as medicare, I think that any man who wants a prostate exam should see a urologist. I see mine twice a year and the visits and tests are covered. A GP also might not do enough prostate work to be as up to date as a urologist.
Sidebar on medicare: My anuual physical always included a vitamin panel which was very useful to determine which supplements were effective and needed and which supplements I didn't need. This year, my physical didn't include the vitamin panel. Doc explained that medicare doesn't cover it anymore so he stopped ordering it. I had him do it and paid for it myself.
@beachdog It's no wonder that prostate cancer is the second leading cancer in men because it goes undetected until it spreads to other organs and bones. Then Dr's start looking at and treating multiple cancers. This is prostate awareness month and who does the health care professionals preach to (Men). Like we should know what goes on there and what tests need to be done and how often etc. etc. to detect cancer. Insurance companies, medicare, and politicians make monetary decisions related to healthcare.
A few years ago they said women do not need annual mammograms even though breast cancer is the most common cancer in women. Women were furious.
I really think prostate awareness needs to be targeted at health care professionals as well as men. If we need to see a urologist for detection then make it part of our exam.
-
Like -
Helpful -
Hug
1 ReactionHi, my husband just came back from a radiation oncology consult. He had a prostatectomy 8 yrs ago and PSA now rising, 0.
24. He will be having PSMA to see if cancer is just in the prostate bed or spread. Either way, it was suggested he have 39 radiation treatments with probable nasty side effects. Would you mind sharing what doctor your partner went to at Mayo? Thanks