Prostate Cancer

• Because prostate cancer is the most common cancer affecting men in the U.S.
• Because if caught early, it's one of the most treatable cancers.
• Because early prostate cancer often has no symptoms.
• Because checking his prostate could save a man's life.

Why aren't men standing in line to get their prostates checked? One reason is the widespread existence of some myths that either scare men or lead them to believe that they can safely ignore their prostate.

The most common myth is that prostate cancer is an "old man's disease," which is a half truth. Certainly, a man's chance of getting prostate cancer increases dramatically with age. That doesn't mean men under 70 don't need to get screened.

Two other myths are frightening, but false. One is that if a man has symptoms, he has prostate cancer. Absolutely not true. Benign prostate hyperplasia (enlarged prostate) is very common, very treatable, and is not cancer.

The other terrifying myth is that if a man gets diagnosed with prostate cancer, he's going to die. In reality, about 90 percent of men diagnosed annually are treated successfully, according to the American Cancer Society (ACS).

Another myth is that prostate cancer treatments remove all sexual function and bladder control. While these effects are possible to some degree, they are by no means a certainty. New nerve-sparing and robotic surgeries produce fewer side effects and faster healing than previous methods.

The same good news applies to new radiation techniques like implanting tiny radioactive seeds to radiate a tumor, and "mapping" tumor size, shape, and location so external radiation can be delivered only where it's needed. Both techniques spare surrounding tissue, meaning side effects are generally minimal and temporary.

Most men are familiar with one test, the digital rectal exam, or DRE. In this test, the doctor feels the prostate gland to see if it's enlarged or abnormal in any way. The other commonly administered test, usually used in conjunction with the DRE, is a blood test that measures a man's PSA, or prostate specific antigen, which is an enzyme in the blood.

If the prostate begins to make too much PSA, it could be a sign of an enlarged prostate, inflammation, or possibly cancer. So a rise in PSA could signal the need for a doctor to investigate further.

Since every man's PSA will change over time, the rate of change is often more important than any single PSA score. If you are in a higher-risk group, including men with a family history of prostate cancer or African American men, talk to your physician about routine PSA testing.

The following symptoms should not send a man into panic mode, but they should send him to his doctor. It may not be cancer, but if it is, the earlier it is discovered, the better chance of treating it successfully. Call for an appointment if you have:

• Pelvic pain.
• Painful ejaculations.
• Frequent need to urinate.
• Blood in the urine.
• Weak or interrupted urine stream.
• Loss of weight or appetite.

The odds of getting prostate cancer are lessened if certain daily practices are adopted. The first important habit is eating a low-fat diet. Reducing fat in your diet will help cut fat from your middle. It's also helpful to eat more fruits and vegetables. Frequent exercise is also important. Set a goal that is achievable, like walking with a buddy or a significant other. The most obvious recommendation is to quit smoking. HMSA's stop smoking services can help.

If you have symptoms and are worried, or if you have already been diagnosed with prostate cancer, you may feel alone in this situation, but you're not. You can call the Hawaii Prostate Cancer Coalition (HPCC) Hotline or the American Cancer Society (ACS) and talk to another man who has gone through the same thing. Be proactive by learning more about prostate cancer screening, support groups, and other resources for men who have survived or are living with prostate cancer.

The HPCC hotline number on Oahu is (808) 487-3295. The toll-free number on the Neighbor Islands is 1 (877) 626-4722. The ACS number on Oahu is (808) 595-7544.

Unlike women who run races, raise money for research, advocate mammograms, and talk about breast cancer in every public forum they can find, men remain largely silent about prostate cancer. Consequently, although prostate cancer is about as common as breast cancer, prostate cancer awareness among men is much lower than breast cancer awareness among women. If men want their life expectancy to be as long as it is for women, they need to speak up, raise awareness about prostate cancer, and get screened.