More than 189,000 fathers, friends and brothers will be diagnosed with prostate cancer this year in the United States. According to the American Cancer Society, prostate cancer ranks behind skin cancer a the most common type of cancer affecting American men. This private disease has captured public attention with a key message: early detection of prostate cancer may increase treatment options and save lives. Early detection begins with a checklist of risk factors and guidelines for testing. While any man may get prostate cancer, the odds increase after age 50. The disease occurs more often in African-American men and in men who have a father or brother with prostate cancer. MUSC Hollings Cancer Center recommends that beginning at age 50 – or younger for those in high-risk groups – men should have an annual screening for prostate cancer. Screening includes a digital rectal exam and a blood test that measures a protein – called prostate specific antigen (PSA) – produced by prostate cells. Typically, prostate cancer does not produce any symptoms in its early stages. As a result, cancers found during an annual screening are usually smaller and less invasive than cancers discovered once symptoms develop. Symptoms of advanced disease may include difficulty with urination and bone pain. Because prostate cancer tends to advance slowly, MUSC urologist Thomas Keane, M.D., says a diagnosis is not necessarily cause for immediate alarm and instant action. Dr. Keane has extensive experience in dealing with prostate cancer and directs the MUSC Urology Services. "Certainly, the cancer needs to be addressed and treated. But patients don’t need to panic and take the first treatment that comes along. Men have a variety of options, and they need to consider what is best for them." After a diagnosis, Dr. Keane advises patients to read as much as possible about prostate cancer, consider getting second opinions from both a surgeon and a radiologist, and weigh the benefits and risks of all options before making a decision about treatment. MUSC Hollings Cancer Center offers the complete range of treatments for prostate cancer, as well as methods for addressing some of the common, manageable side effects of certain treatments such as impotence and incontinence. Although treatments vary according to the size and scope of the cancer - and the man’s individual needs - options include the following: Observation Also known as watching and waiting, observation does not involve active treatment. Patients may track their PSA and get a biopsy on a yearly basis to monitor the cancer’s progress. Hormone therapy Certain medications may be used to lower levels of testosterone, which fuels prostate cancer. Surgery Physicians remove the prostate gland and possibly some surrounding tissue to try to eliminate cancer from the body. Radiation The goal of radiation is to kill or shrink cancer cells with high-energy rays. MUSC offers two types of radiation for prostate cancer. External beam radiation is delivered by a machine, similar to getting a standard x-ray. With a newer form of radiation called brachytherapy, physicians implant tiny, radioactive "seeds" in the prostate to attack the cancer. Cryotherapy Cryotherapy involves freezing the prostate gland to destroy cancerous cells. Cryotherapy might be a treatment option for men who do not have success with radiation. Chemotherapy Men may choose to participate in clinical trials for the latest chemotherapy treatments for prostate cancer some of which take place at MUSC Hollings Cancer Center. "Men need to look at all of the therapies and make a list of what is involved and what they’re seeking to achieve," Dr. Keane says. "They should not be afraid to consult with several physicians and gain as much knowledge as possible about prostate cancer. This is one of the most important decisions a man can make. We’re here to help them with that decision and supply comprehensive care." To schedule an annual prostate cancer screening, men should contact their primary care physician, consult MUSC Med-U-Nurse or call MUSC Health Connection at 792-1414 or 1-800-424-MUSC. - Reprint from MUSC's Checkup publication, Fall 2002 | 
