Speaking Up About Prostate Cancer
Above photo: Ken Griffey Sr.
By Laura Drucker
Ken Griffey Sr. had reason to be worried about his prostate health. The former Cincinnati Reds baseball player, father of National Baseball Hall of Famer Ken Griffey Jr., lost four uncles to prostate cancer. His mother continually stressed to him the importance of regular prostate screenings due to his family’s history. In 2006, at the age of 56, Griffey got the diagnosis his mother had been wary of—he had prostate cancer.
“The ‘C word’ is tough,” Griffey says. He struggled with how to tell his family members, specifically his two sons, Ken Jr. and Craig, whose mother had been diagnosed with colon cancer that same week. When he finally told them, he was careful to explain that if prostate cancer is detected early it can be curable.
“I explained to [them] that the doctors caught it early, and when they catch it early you have a [good] chance of survival,” says Griffey, who has remained cancer-free for the past decade.
About one in seven men will be diagnosed with prostate cancer in their lifetime; typically they are diagnosed around age 66, according to the American Cancer Society. About one in 39 of those who are diagnosed will not survive.
Griffey, along with Ken Jr., now travels the country with Bayer’s Men Who Speak Up campaign, encouraging men to discuss prostate cancer, get screened if they suspect something is wrong and speak up about symptoms that might mean the disease is progressing. The conversation is especially important during September, Prostate Cancer Awareness Month.
“Men don’t want to talk about it,” Griffey says. “They’re a little macho, and the area is below the belt. They just won’t talk about certain things.”
But not talking about prostate cancer can have serious consequences. If caught early, prostate cancer is generally localized and readily treatable, but advanced prostate cancer can spread to different parts of the body, most typically to the bones, making it significantly harder to treat.
Who’s at risk?
The biggest risk factor is age (most prostate cancers are diagnosed in men over 65), followed by family history and ethnic origin, says Mebea Aklilu, MD, medical oncologist at Advocate Illinois Masonic Medical Center. African Americans are at an especially high-risk—they are 1.6 times more likely than Caucasian men to be diagnosed with prostate cancer and 2.4 times more likely to die from it, according to the Prostate Cancer Foundation.
Recognizing the signs of prostate cancer is not always easy.
“The symptoms of prostate cancer are pretty nebulous.” Aklilu says. Early prostate cancer might have no symptoms. And some symptoms, such as frequently feeling the urge to urinate, may simply indicate benign prostatic hypertrophy (BPH), also known as an enlarged prostate, a common, but not necessarily harmful diagnosis.
More worrisome symptoms, Aklilu says, include blood in the sperm or urine, weight loss and pain in the pelvis, hips, ribs, spine and upper thighs. Though these symptoms can be indicative of prostate cancer, they also can be attributable to prostatitis (inflammation of the prostate) or a prostate infection.
Opening the dialogue
The current go-to screening method for prostate cancer is the prostate-specific antigen (PSA) blood test. Elevated PSA levels can indicate that a patient’s prostate needs to be more closely monitored.
The PSA test “helps inform us about how much we should be screening in the future,” says Joshua Meeks, MD, a urologist at Northwestern Memorial Hospital. If PSA levels are elevated, a physician may decide to rescreen in six to eight weeks to make sure it’s a true elevation or to increase the frequency of surveillance in the future. If the PSA level is particularly high, the physician may recommend a biopsy.
There are limitations, though. “As men get older, their prostate gets larger and the reasons for having an elevated PSA are greater,” Meeks says. The PSA test cannot tell you if you have cancer, but high PSA levels are an indication to follow up with your doctor.
While the U.S. Preventive Services Task Force and the American Urological Association currently recommend against routine PSA screenings because of overdiagnosis and overtreatment, the decision to get screened is left to the discrepancy of a man and his physician based on individual risk factors and overall health.
“The PSA Test is quick and easy, but we’re not sure that it improves survival,” Aklilu says.
Getting the conversation started is one of the most important parts of prostate cancer screening. Routine discussions with a primary care physician can help men make informed decisions about whether screening is needed and how to get treatment if necessary.
“The worst scenario is to not have any information. The second worst is having information but nobody to discuss it with,” Meeks says. “There has to be someone there to have that discussion with the patient.”
Knowing the symptoms and being open to discussing them with a physician are important steps. For men over 40, the best thing they can do is open the dialogue. That means notifying primary care physicians about any factors, such as family history, that may put them at greater risk for prostate cancer. Doctors can then help patients make the call about whether a screening would be valuable.
As far as preventing prostate cancer, the best steps you can take, Aklilu says, are healthy lifestyle actions you should be taking anyway—eat a healthy diet, exercise regularly and don’t engage in harmful habits like cigarette smoking. While no cancer can be fully prevented, risk reduction can go a long way toward helping men avoid a prostate cancer diagnosis.
Originally published September 29, 2016
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