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  • Did You Know Prostate Cancer Screening Has Changed? Find Out Why It’s Better Now.
Article Category: Highlights

Did You Know Prostate Cancer Screening Has Changed? Find Out Why It’s Better Now.

And why it’s time to have a conversation with your doctor.

Published on September 21, 2022

Last updated 01:15 PM August 31, 2023

Illustration of scoreboard in stadium. Text reads "Hey man, know your stats, PSA < 4.0"

Quick history lesson: In the 1990s, U.S. doctors adopted the prostate-specific antigen test—or PSA—to identify prostate cancer early, when it’s more treatable. While the PSA helped more men get diagnosed, concern was raised over the risks versus benefits of biopsies, procedures and treatment. In response, the U.S. Preventive Services Task Force gave a controversial recommendation against routine screening with PSA in 2012.

But with new evidence from a variety of credible studies, they changed their recommendation in 2017. The current Task Force recommendation focuses on men having a conversation with their doctors about their risk for prostate cancer and the risks and benefits of screening.

Why did the guidelines change?

Prostate cancer is the most common cancer diagnosed in males after skin cancer. According to projections by the American Cancer Society, there will be twice as many new prostate cancer cases diagnosed as lung cancer this year.

“The prevalence of the disease cannot be ignored,” said Wellstar Health System Chief of Primary Care and Medicine Service Line Dr. Jeffrey Tharp, a primary care physician. “Early-stage prostate cancer has higher survivability than prostate cancer diagnosed in later stages.”

Dr. Tharp pointed out that while guidelines have changed, so have the way doctors diagnose and treat prostate cancer. An elevated PSA does not automatically mean a cancer diagnosis. And when cancer is diagnosed, some care options have no side effects.

Read on to learn:

  • Who should have a conversation with their doctor about prostate cancer screening, and when
  • Who is at higher risk
  • How the reason that’s holding some men back has changed
  • What is a PSA and why having them at regular intervals is important
  • Care options for prostate cancer

Some men have anxiety about what the treatment would be and the long-term effects of treatment. We have active surveillance and other means of preserving bodily function, especially when we find prostate cancer in the earlier stages.

- Dr. Jeffrey Tharp

Chief of Primary Care and Medicine Service Line, Primary Care Physician

Who should discuss prostate cancer screening—and when

If you have a prostate, you should discuss whether screening is right for you with your primary care doctor, nurse practitioner or physician assistant:

  • Starting at 40 if…you have a strong family history of prostate, breast, ovarian, uterine, colon and pancreatic cancer as well as melanoma—particularly if they were early onset or you have a known family history of carrying the BRCA1 or BRCA2 gene
  • Starting at 45 if…you’re a Black man, meaning you carry twice the risk of dying from prostate cancer 
  • Starting at 50 if…you have a typical risk level 

Is fear stopping you? 

“Some men have anxiety about what the treatment would be and the long-term effects of treatment,” said Dr. Tharp. 

But, he noted, treatment has changed a lot since the early 2000s.

“We have active surveillance and other means of preserving bodily function, especially when we find prostate cancer in the earlier stages,” he said. 

What exactly is a PSA?

A PSA test is a simple blood test you get at your doctor’s office.

The test measures the prostate-specific antigen, a substance in the body that is related to the presence of prostate cancer. However, a rise in PSA can also be caused by other factors such as recent sexual activity, exercise, prostate enlargement, age and infection.

“When someone has an elevated PSA for the first time, we put it in context,” Dr. Tharp said, indicating that doctors don’t automatically diagnose prostate cancer because of an elevated PSA. “A one-time PSA is important, but a trending PSA helps us see the bigger picture."

Once a PSA test result flags the possibility of cancer, primary care doctors typically refer patients to a urologist who specializes in prostate cancer treatment. 

Patients have a team helping them achieve their best outcome

At Wellstar, the patient’s doctors are part of a multidisciplinary prostate cancer care team at Wellstar who hold regular conferences dedicated to diagnosing, staging and planning care together so patients have the best outcomes. The prostate cancer team includes urologists, radiation oncologists, medical oncologists, pathologists, radiologists, primary care physicians and nurse navigators.  

“Once a man has been diagnosed with prostate cancer, our experienced physicians, navigators and nurses help him navigate the decision-making process around prostate cancer treatment,” said Dr. Olusola Davies, Wellstar radiation oncologist.

Because of the variety of prostate cancer types, how quickly their prostate cancer grows and other individual factors, each person’s treatment is tailored to them. Care plans may include active surveillance, prostate cancer surgery or radiation therapy.

“It’s important to give men time to absorb the information coming from the treatment team, ask questions and review things they might not be sure about,” Dr. Davies said.

Good news: newer treatments eliminate or reduce side effects

Many men with low-grade, early-stage prostate cancer choose to follow a treatment plan of active surveillance using a guideline-based protocol with their Wellstar physician. This option reduces unnecessary side effects from therapy and improves their quality of life.

In fact, more than 70% of Wellstar patients diagnosed with low-risk prostate cancer opt for active surveillance.

Various types of prostate cancer surgery, including minimally invasive robotic procedures, have the potential to spare nerves and preserve sexual function. And newer radiation therapies reduce radiation exposure to healthy tissue.

“Patient outcomes have been very good at Wellstar, and we have a well-coordinated interdisciplinary team to care for our patients,” said Dr. Tharp.

Make an appointment with your doctor today to discuss if the time is right to start screening for prostate cancer.

 
 

Tags

Jeffrey Lanier Tharp Olusola Obayomi-Davies Cancer Care
Primary Care Mens Health
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Illustration of group of men

Highlights

Prostate Cancer Screening in Black Men

Screening for prostate cancer is crucial for early detection and to help provide the best possible outcome. It is especially important for Black men to be vigilant about screening, as they are disproportionately impacted by this cancer.

About 1 in 6 Black men will be diagnosed with prostate cancer in their lifetime, compared to 1 in 8 white men, according to a report from the American Cancer Society. Prostate cancer is the second leading cause of cancer death in Black men.

The American Cancer Society recommends that men at an average risk of developing prostate cancer begin screening when they are 50, but Black men should start earlier—at age 45 if they have no family history of prostate cancer, and at age 40 if any of their male relatives have had prostate cancer. Wellstar takes a personalized approach to cancer screenings, with clinicians discussing benefits versus risks of screening and helping patients evaluate their risk.

“Despite many physicians being aware of this and following this practice, Black men continue to be diagnosed with and die from metastatic prostate cancer. This is a trend that desperately needs to be reversed,” said Wellstar Primary Care Physician Dr. Earl Stewart. “We have adequate screening tools that do not even require a digital rectal examination.”

The Prostate-Specific Antigen (PSA) blood test is more accurate than the digital rectal examination in helping to detect prostate cancer, according to Dr. Stewart. Patients should also discuss family history with their relatives. “Patients knowing their family history is so crucial in having those discussions with primary care physicians to determine the best age at which to start screening,” Dr. Stewart said.

Screening for prostate cancer is as simple as making a preventive appointment with your primary care physician, discussing your family history with him or her, and having a PSA blood test. This test may be performed during an annual physical or wellness visit. Shared decision making between physician and patient is important to discuss your risk, your need for testing and next steps to take if your PSA level is elevated and concerning. Knowing your risk can save your life.

“I know many personally who are near and dear to me who had the disease and who unfortunately died from complications of metastatic prostate cancer,” Dr. Stewart said. “I know many more who lived because they had the conversation and dared to move forward with appropriate screening at the appropriate age.”

Learn more about prostate cancer care at Wellstar.

Keep reading
Doctor holding model of reproductive system

Highlights

4 Common Questions About Gynecologic Cancer—Answered

The gynecologic oncologists at Wellstar care for women at all stages of life, treating a variety of conditions with compassion and offering advanced care options. Our team are experts in treating cancers such as uterine, ovarian, cervical, vaginal and vulvar cancers. Here, we answer common questions about gynecologic cancer care with the help of Dr. Rosa Miller Polan, a gynecologic oncologist at Wellstar Cobb Medical Center. 

What is a gynecologic oncologist?

Gynecologic oncologists are specialists trained in the multidisciplinary management of patients with cancers of the female reproductive tract. Trained originally in obstetrics and gynecology, gynecologic oncologists treat patients with complex benign gynecologic issues, as well as gynecologic cancer patients who may need surgery, chemotherapy, immunotherapy or a combination of different treatments. 

When should you seek care?

Gynecologic cancers have different warning signs. When a person experiences concerning symptoms, a physical exam, including a pelvic exam, should be performed. Cervical and vaginal cancer symptoms include abnormal vaginal discharge, vaginal bleeding and pain. The most common warning sign for uterine cancer is abnormal vaginal bleeding. In postmenopausal women, any bleeding or spotting is abnormal and should prompt an evaluation. 

Ovarian or fallopian tube cancer symptoms include bloating, constipation, pelvic or abdominal pain and difficulty eating or feeling full quickly. Vulvar cancer symptoms include itching, burning, discoloration, and new bumps or lumps on the skin outside of the vagina. 

Who is at risk for developing gynecologic cancer?

Women who smoke cigarettes are at elevated risk for cervical, vaginal and vulvar cancer development. People who are immunosuppressed and those who have tested positive for the human papillomavirus (HPV) are also at increased risk. Genetics can contribute to the development of uterine, ovarian or fallopian tube cancers and these types of cancers can run in families. Obesity and use of hormone replacement therapy can put women at risk for the development of uterine, ovarian and fallopian tube cancers. A history of infertility, endometriosis and pelvic radiation are also risk factors for developing gynecologic cancer. 

What services are available at Wellstar?

At Wellstar, gynecologic oncologists provide comprehensive care for patients with gynecologic cancers, including administering chemotherapy and performing surgeries when needed. As high-volume pelvic surgeons, gynecologic oncologists also care for patients who need elective and emergent complex benign gynecologic surgery.

For many patients, robotic-assisted surgery offers a minimally invasive approach with less associated blood loss, shorter hospital stays and fewer post-operative complications. Gynecologic oncologists are some of the top users of the innovative DaVinci 5 robotic surgery platform. Performing complex gynecologic cancer surgeries, minimally invasive or otherwise, requires the type of highly specialized and multidisciplinary teams that work at Wellstar—and an infrastructure of resources to ensure patients have access to best-in-class care in their own backyard.

Learn more about gynecologic oncology at Wellstar at wellstar.org/gyncancer. 

Keep reading
Provider checking patient's blood pressure

Highlights

Team Up with Wellstar to Fight These Men’s Health Issues

If you’re a sports fan, you’re probably glued to every game, rooting for your team and analyzing every play. But are you as vigilant with your own health? 

In addition to knowing your health stats—those important numbers like blood pressure, cholesterol and blood sugar—you should also watch for health conditions that more commonly impact men. 

An annual physical gives you the opportunity to ask your clinician questions about your health, and you’ll get a few quick, crucial health screenings that can catch issues early and put you on track for staying well.

“See your primary care provider at least once a year to check in on your well-being and stay up to date on essential screenings you may need,” said Wellstar Primary Care Physician Dr. Facia Dew. “Your provider will customize care based on your health history, age and other factors to help you feel your best.”

Take action against illness

Some illnesses are more likely to affect men than women, so men should be especially mindful about taking steps to prevent these issues:

Lung cancer

Men are slightly more likely to get lung cancer—the lifetime risk for men is 1 in 17, while it’s 1 in 18 for women, according to the American Cancer Society. Black men are about 12% more likely to develop lung cancer compared to white men. Decrease your risk of lung cancer by avoiding smoking.

With a low-dose CT scan of the chest, it only takes a few seconds to check in on your lung health. An order from your healthcare professional is required for a lung cancer screening. Contact your Wellstar primary care team or a pulmonologist to discuss if screening is right for you.

Parkinson’s disease

Men are 1.5 times more likely than women to have Parkinson’s disease, according to the Parkinson’s Foundation. Wellstar neurologists and neurosurgeons are experts in helping patients manage this condition.

Kidney stones

The risk of kidney stones is about 11% in men and 9% in women, according to the National Kidney Foundation. You can reduce your risk of kidney stones by staying hydrated and eating a low-sugar, low-sodium diet. Your care team can help you evaluate your risk factors, including personal and family history, obesity and being 40 or older. 

Prostate cancer

While all men are at risk for prostate cancer, Black men are more likely to get prostate cancer and are more commonly affected at younger ages. Men who are 50 or older should ask their doctor about testing, and Black men should discuss testing with their care team at age 45. If you have a family history of prostate cancer, you should also consider screenings at a younger age, and your healthcare professional will discuss options with you. 

Form healthy habits

According to Wellstar Urologist Dr. Scott Miller, men need to stay active and stay away from smoking. He also noted a few lifestyle changes that are sometimes overlooked can make a difference in how you feel.

“What’s often neglected is a full and consistent night’s sleep,” Dr. Miller said. “And keep stress under control—too much stress can negatively impact our immune systems.” 

Find a primary care professional near you.

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