Knowing the signs: Encouraging prostate cancer screening - The Morning Journal

Prostate cancer impacts about 11 percent of men at some point in their lives with more than 200,000 cases and 30,000 deaths annually attributed to the disease.

September was Prostate Cancer Awareness Month, and physicians are reminding people of the importance of understanding the risk factors and getting checked.

Dr. Israel Cajigas, family medicine physician at Mercy Health, said guidelines from the United States Preventative Services Task Board in 2018 stressed screening prioritize men between the ages of 55 and 69.

“This is kind of where we're going to see that the highest risk for men, so age is definitely one risk factor," Cajigas said. "Younger than 55, it's a little bit too early to screen, the benefits would not outweigh any potential risks.

"And age 70 or above, we see less of the benefits, also."

Research suggests African American and Hispanic men are at heightened risk of dying from the disease, Cajigas said, pointing to studies showing Black men are dying at a rate of 4.2 percent, more than double the rate of Caucasian men of 2.3 percent.

Hispanic men are dying at a rate of three percent, he said.

Pull Quote

“The goal is, if we catch that cancer, we catch it early and we catch it localized so that the treatments are much more successful.”

Dr. Israel Cajigas

Many of the large research studies did not have a large enough sample of African American men in order to discern why the rates are increased, leaving researchers to fill those gaps in future studies.

“And the question is, is there something?" Cajigas asked. "Is there some kind of genetic predisposition? Is this a socio-economic issue?

"It really has no hard data in terms of why that is the case. The numbers have just showed that, that is the case in terms of prevalence and risk for mortality.”

Additional risk factors include having a close relative with a history of prostate cancer, which increases a person's chances of getting the disease by about 30 percent.

A history of smoking is another factor.

Catching prostate cancer early is a key factor in successful treatment with some of the newer studies showing that for every male screened for prostate cancer, it will prevent 1.3 deaths, Cajigas said.

“So, if you if you extrapolate those numbers out, you figure there's 150 million men in the United States," he said. "… If you take that same percentage, you're looking at 150,000 men whose lives would be saved, and you're looking at 450,000 that’ll be prevented from going into metastatic cancer, which of course will be much more difficult to treat.

“The goal is, if we catch that cancer, we catch it early and we catch it localized so that the treatments are much more successful.”

However, for some men, encouraging them to start the conversation with their physician is half the battle, Cajigas said.

The symptoms

Many of the symptoms associated with prostate cancer are not always detectable, making early detection and treatment more difficult in certain situations, he said.

Cajigas joked that women sometimes are the stronger of the species in typically being more proactive about being tested.

In his experience, Cajigas said it's often more difficult to get men to buy in when there are not clear-cut symptoms.

He compared the buy-in to maintaining a vehicle.

“If you own the car, and never took it for a tuneup or for an oil change, you never kept it maintained, the car's not going to last very long,” Cajigas said. “So, it's the same idea with the body; you don't only want to see the doctor when you're sick, or when there's a problem.

"You want to be proactive, trying to keep yourself healthy about maintaining health.”

Through public education programming and continuing to educate patients, the importance of getting screened and focusing on preventative care is making a difference, Cajigas said.

“It's all about kind of stressing that we're trying to be preventative here, have those discussions, because a lot of times, we might open their eyes to the importance of getting screened," he said. "And a lot of men, once they hear the prevalence of these conditions, they're like, oh OK, well, I probably should get checked out.”

Sudden changes in urination combined with secondary symptoms like loss of appetite, sudden unexplained weight loss, blood in the semen and general sickness are tell-tale signs to go see a doctor, especially if they last more than two weeks.

Cajigas explained that as men get older, the prostate gradually enlarges, making urination more frequent with the urine stream becoming weaker.

A sudden shift in these habits could indicate a larger problem, he said.

The good news is that prostate cancer is very treatable with three main options including active surveillance, radiation treatment and surgical options.