Prostate cancer is the most common type of cancer among men in the United States after skin cancer, and about one in eight men will be diagnosed with the disease during his lifetime, according to the American Cancer Society. It is also one of the most treatable types of cancer, with high survival rates. While the screening process is often quick and painless, many are intimidated by the exam and therefore put it off, according to urology experts at NewYork-Presbyterian.
In fact, research shows that men — regardless of income or ethnicity — are less likely than women to regularly schedule doctor visits for preventive care. This includes prostate exams.
“There are so many men who are afraid of what they think being evaluated for prostate cancer entails that they completely avoid the topic,” says Dr. Alfred Winkler, chief of urology at NewYork-Presbyterian Brooklyn Methodist Hospital and an assistant professor of clinical urology at Weill Cornell Medicine. “Our goal is to offer comprehensive services that can help men get the preventive care and screenings they need so they can stay healthy.”
Health Matters spoke with Dr. Winkler and members of his team to get the facts about prostate cancer, as well as dispel some common misconceptions about prostate cancer screenings.
Fact #1:When getting screened for prostate cancer, a rectal exam is not always necessary.
According to Dr. John Graham Jr., a urologist at NewYork-Presbyterian Brooklyn Methodist Hospital and an assistant professor of clinical urology at Weill Cornell Medicine, prostate cancer screening does not always mean having a rectal exam. “Look at your first appointment with your doctor as a conversation,” he says. “You can expect a blood test if you consent to it and a digital rectal exam can be a part of your exam if that’s something that you feel comfortable proceeding with after a conversation with your doctor.”
Fact #2: The earlier you catch it, the more treatment options you will have.
Prostate cancer is highly treatable if caught early. According to the American Urological Association, those with average risk should start prostate cancer screenings beginning at age 55. But individuals should really begin talking with their doctor in their 40s to see if they need prostate cancer screening earlier than age 55 based on their risk level.
Treatment can vary depending on the stage of diagnosis. “Each treatment plan is tailored to the patient,” says Dr. Graham. “It’s not a cookie-cutter, one-size-fits-all approach — it’s all individualized.”
Dr. Winkler adds, “The earlier a patient deals with this issue, the more choices they have. The longer a person waits and the more they delay, the narrower those choices become.”
Fact #3:An abnormal PSA test does not always indicate prostate cancer.
While helpful in early prevention, a PSA test — a blood test that is used to screen for prostate cancer — is not always 100% accurate. A PSA test can be abnormal for many reasons other than prostate cancer. One reason could be an enlarged prostate, a noncancerous, common condition that impacts men as they get older. “PSA tests are just one piece of the overall screening puzzle, and discussing this test with a urologist can be helpful,” says Dr. Meenakshi Davuluri, an attending urologist at NewYork-Presbyterian Brooklyn Methodist Hospital and an assistant professor of clinical urology at Weill Cornell Medicine.
Fact #4:Black men have a higher risk of prostate cancer.
Studies show that one in seven Black men will develop prostate cancer in their lifetime. “African American men are two times more likely to be diagnosed with prostate cancer and are more likely to be diagnosed with a more aggressive form of cancer,” says Dr. Davuluri. “So screening for those high-risk populations is very important.”
If your father, your brother, or another close relative has had prostate cancer, be sure to tell your doctor. They may want you to be screened earlier since a family history increases the potential risk of prostate cancer. The bottom line: If you are in a high-risk group, speak to your doctor about the risks and benefits of yearly rectal exams and PSA tests.
Fact #6:You may be asymptomatic and still have prostate cancer.
Prostate cancer can be silent, often with no discernible symptoms until the cancer has spread outside the prostate. “Early, treatable stages of prostate cancer are almost always asymptomatic,” says Dr. Graham. This is why preventive screenings are so important.
Fact #7:As you get older, your risk of prostate cancer increases.
After you turn 65 years old, your risk of prostate cancer increases exponentially. About six in ten men who are diagnosed with prostate cancer are over 65.
Fact #8:Overall physical health and lifestyle play a role.
According to Dr. Winkler, healthy lifestyle changes can make a difference in reducing the risk for prostate cancer. His recommendations:
● Maintain a healthy weight.
● Eat less red meat and more green, leafy vegetables.
● Exercise regularly.
● Don’t smoke.
● Manage stress.
“Following healthy dietary guidelines, making simple lifestyle changes, and getting recommended screenings can all reduce the risk of prostate cancer, but men in high-risk groups should be under a physician’s care,” says Dr. Winkler.
Protect yourself by getting screened for prostate cancer. Learn more about prostate cancer treatment at NewYork-Presbyterian Brooklyn Methodist Hospital and make an appointment with a urologist.
Alfred Winkler, M.D., MBA, is chief of urology at NewYork-Presbyterian Brooklyn Methodist Hospital. He is also an assistant professor of clinical urology at Weill Cornell Medicine. Dr. Winkler believes that patient education is essential to the collaborative effort between physician and patient to achieve an optimal outcome. In his practice, he spends the extra time to make certain his patients have a thorough understanding of both their illness and the treatment options available. Dr. Winkler’s particular areas of focus are men’s health, stone disease, and voiding dysfunction in both men and women.
John N. Graham Jr., M.D., is a urologist at NewYork-Presbyterian/Weill Cornell Medical Center and NewYork-Presbyterian Brooklyn Methodist Hospital. He is also an assistant professor of clinical urology at Weill Cornell Medicine. Dr. Graham has fellowship training in complex robotic approaches to malignant or benign pathology in the kidney, ureter, bladder, prostate, and other retroperitoneal processes. He also has experience in providing cutting-edge technology for benign prostatic hyperplasia. In addition to his clinical work, Dr. Graham has a specific interest in education. He has experience as a reviewer for peer-reviewed international scientific journals, has presented at national meetings, and is published in peer-reviewed academic journals. He is a member of the American Urology Association (AUA) and the New York Section of the AUA. Dr. Graham has been working within the Brooklyn community for more than five years.
Meenakshi Davuluri, M.D., M.P.H., is an attending urologist at NewYork-Presbyterian Brooklyn Methodist Hospital and an assistant professor of clinical urology at Weill Cornell Medicine. She has published numerous papers within urology as well as authored chapters for urologic textbooks. She also has served as a reviewer for major urologic journals. She is passionate about disparities in healthcare and is a fellow with the Department of Population Health Sciences at Weill Cornell Medicine.Dr. Davuluri’s current research focuses on outcomes associated with prostate cancer treatment and improving the quality of life in prostate cancer survivors. She is an active member of the AUA, New York Section of the AUA, and the American Medical Association.