HealthView column: Fighting prostate cancer in the Roaring Fork Valley
I tell my patients the two biggest risk factors for developing prostate cancer are things they cannot control: gender and age. It’s true, as men age, their risk of developing prostate cancer increases exponentially. Nearly 60 percent of all prostate cancers are diagnosed in men over the age of 65. I see roughly 20 new cases each month, and it’s a cancer that can be successfully managed.
There are other risk factors we can’t control for such as family history and race (prostate cancer is more prevalent in black men), but there is plenty you can do to make up for it with the risk factors you can control. In addition to healthy lifestyle choices, the next best thing men can do to reduce their risk for prostate cancer is to have a relationship with a primary care physician. Establishing baseline personalized health data by completing an annual exam, and having an individualized and thoughtful conversation with a primary care physician can provide earlier intervention, if necessary. This is especially important because prostate cancer shows no significant symptoms in its beginning stages. Many people find out they have the cancer only once a prostate-specific antigen (PSA) test is done.
The PSA test is a blood test used primarily to screen for prostate cancer. The PSA test can detect high levels of PSA that may indicate the presence of prostate cancer. However, many other conditions, such as an enlarged or inflamed prostate, can also increase PSA levels. There has been much written regarding PSA testing. The upside of the PSA is that early diagnosis of aggressive prostate cancers can improve survival. Consequently, when screening finds cancers that would never cause symptoms or harm during a patient’s lifetime, it results in the major downside of PSA screening: over-diagnosis. Not every prostate cancer diagnosis warrants an intervention, and I encourage patients to talk to their health care provider about the course of treatment that best suits them based on their unique and personal health situation. Important factors to consider are the stage and grade of the cancer, age, other health conditions (genetics, family history), the likelihood that the treatment will be effective, and personal feelings on the side effects from each treatment option. Currently, treatment options range from active surveillance, to surgery to radiation therapy, hormone therapy, chemotherapy, and novel treatments such as immunotherapy through national clinical trials.
As a radiation oncologist, I see patients who have chosen radiation therapy to treat their prostate cancer, including external radiation via our linear accelerator, and internal radiation, also called brachytherapy. A modern type of brachytherapy, HDR, is an advanced method we use to treat prostate cancer. Temporary radioactive seeds are implanted directly into the affected tissue, reducing the exposure to unaffected tissue areas.
We also now have a clinical trial underway, evaluating two novel, shorter-course external radiotherapy options for prostate cancer. We are the only cancer center in Colorado outside of the University of Colorado with these studies and platform, which takes national accreditation and proof of expertise in cancer care to achieve.
As cancer treatment continues to evolve, my priority will always be the treatment option that works best for each individual patient. September is Prostate Health Awareness Month — be informed about your options and know the symptoms: the need to urinate frequently, difficulty starting or hold back urination, painful or burning urination, and blood in the urine, among others.
If you’re a male and have not yet had your yearly physical, schedule one today. And ladies, encourage your male loved ones to do the same. If identified and managed appropriately, the five-year survival rate for men diagnosed with prostate cancer is 99 percent.
Peter Rossi, MD, is a radiation oncologist at the Calaway•Young Cancer Center at Valley View. He relocated to the Roaring Fork Valley in 2017 from Emory University Hospital in Atlanta, Georgia. For more information on the Calaway•Young Cancer Center at Valley View, call 384-7570 or visit http://www.vvh.org/calway-young-cancer-center.