Prostate Cancer

 

What's A Guy To Do?

September is Prostate Cancer Awareness Month, But Whether You Get Screened or Not Should Be Between You and Your Doctor

People say sooner or later that every man will get prostate cancer. That’s not necessarily true, but aside from skin cancer, prostate cancer is the most common cancer among men, with more than two million prostate cancer survivors in the United States.

What’s more, there are ways to detect the disease and treat it, which is why health experts want men to be aware of prostate cancer. Sometimes, however, screening and the resulting treatment can have more serious consequences than the disease, which can be very slow-growing and actually not cause any health problems. That is why the Louisiana Comprehensive Cancer Control Program (LCCCP), whose mission is to increase awareness about preventable cancers, and other health experts now recommend that men discuss their particular situation and risk factors with their doctors starting at age 50 (45 for black men). In a collaborative process called “Informed Decision Making,” doctors help men understand the nature of prostate cancer, as well as the risks, benefits and alternatives to screenings, while the man informs the doctor his preferences as to screening participation. That way an informed decision can be made together that is consistent with the man’s preferences and values.

If You Have Symptoms, Consult Your Doctor Right Away

There is no question that if you are exhibiting symptoms, you need to see your doctor. According to the Centers for Disease Control and Prevention, symptoms include:

·         Difficulty starting urination or emptying the bladder completely

·         Weak or interrupted flow of urine

·         Frequent urination, especially at night

·         Pain or burning during urination

·         Blood in the urine or semen

·         Pain the back, hips or pelvis that doesn’t go away

·         Painful ejaculation

Men should keep in mind, howeverthatthese symptoms can be caused by other conditions, that symptoms can vary from man to man, and that some men won’t have any symptoms, so it’s always best to consult with your doctor. That’s especially true if you are older, black, or had a father, brother or son with prostate cancer, as those characteristics are all risk factors for the disease.

The Special Case of Black Men

Prostate cancer impacts black men more than men of other racial and ethnic backgrounds. According to the American Cancer Society, they are 60 percent more likely to be diagnosed with the disease during their lifetime and are more than twice as likely to die from it.

Black men are also diagnosed at a younger age and are more likely to have high-grade, or rapidly growing tumors. Scientists have found genes associated with that increased risk, but these gene differences have not been found in the majority of black prostate cancer patients, so their impact is still unknown.

Much of the difference in these statistics is due to socio-economic factors, as black men are less likely to have health insurance and, in general, uninsured men have lower prostate screening rates, are less likely to get further tests quickly in the event of abnormal screening, and are more likely to be diagnosed with advanced disease.

When men have equal access to health care, such as blacks and whites in the military, the death rate difference narrows considerably – though not totally. There is a lack of race-specific information on prostate cancer, a situation that health experts recognize must be remedied. Given what is known at this time, however, both black and white men are advised to consult with their doctor as to prostate cancer screening and treatment – the difference being that black men should start the discussion earlier, at age 45.

So What Is The Issue With Screening?

Most prostate cancers grow slowly and do not cause harm, while others grow quickly and can spread, causing death. The problem is that the tests we have today cannot distinguish between the two types and men end up often receiving treatment they do not need. And the treatment can often have serious side effects, such as causing men bowel issues or problems controlling their urine, as well as problems having sex. These uncertainties and possible treatment side effects are why health experts are recommending that individual men must learn what they can about prostate cancer and testing, discuss with their doctor and then make an informed decision about what is best for them on an individual basis.

The Louisiana Comprehensive Cancer Control Program (LCCCP) is one of the CDC-funded Louisiana Cancer Prevention and Control Programs (LCP) housed at the LSU Health Sciences Center School of Public Health. 


Louisiana Prostate Cancer Facts


Louisiana has the 2nd highest incidence and 7th highest death (mortality) rate of prostate cancer in the U.S. (Figure 1 & Figure 2). 

Figure 1: click to enlarge

2009-2013 Incidence Data Not Available

Figure 2: Click to enlarge

Louisiana’s prostate cancer incidence and mortality rates are statistically significantly higher than the rest of the country: In 2009-2013: 

  • 154.4 people per 100,000 were diagnosed with prostate cancer, while the national average was 129.5 per 100,000.

  • An average of 23.1 Louisiana residents per 100,000 died each year from this disease, while the national average was 20.6 deaths per 100,000.

Figure 3: Click to enlarge

Figure 4: Click to enlarge

The Greater New Orleans Area, Central Louisiana, Northwest Louisiana, Northeast Louisiana and Florida Parishes have the highest prostate cancer death rates in the state (Figure 3 & Figure 4).

Prostate cancer is an equal-opportunity killer, with Louisiana white men and black men having significantly higher prostate cancer incidence rates than the rest of the country (Figure 5 & Figure 6).

Figure 5: Click to enlarge

Figure 6: Click to enlarge

These estimated and projected costs of care by age, gender and phase of care (per patient) through the year 2020. 

Figure 7: Click to enlarge

They were calculated separately for multiple cancer sites using the most recent available U.S. population projections, cancer incidence, survival, and cost of care data (Figure 7).1


More information on cancer incidence and mortality is available from the Louisiana Tumor Registry (http://sph.lsuhsc.edu/data-use). Statistics other than what this site offers can be requested using the form on the Louisiana Tumor Registry website.

1. National Cancer Institute. Cancer Prevalence and Cost of Care Projections.

https://costprojections.cancer.gov/annual.costs.html