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According to the American Cancer Society, it’s the second most common form of cancer among men—one in six is diagnosed with it. But you won’t see any ribbon campaigns calling for its eradication, and few celebrities are rushing to do public service announcements about it. It’s prostate cancer. And it’s notoriously unmentioned.
Perhaps there’s no spotlight because men are typically private about health matters. Or maybe it’s because one of the ways to determine there’s a prostate problem involves a digital rectal exam during which a urologist checks for abnormalities in the prostate gland (such as swelling). The doctor may also recommend a prostate specific antigen (PSA) blood test in which blood is drawn to look for increased levels of PSA in the bloodstream.
If cancer is found, there’s a variety of possible treatments, depending on the severity of the cancer and the health of the individual. In some instances, multiple treatment paths are chosen.
There are three basic types of surgery. The first, retropubic prostatectomy, involves making an incision from the navel to the pubic bone in order to remove the prostate. Then there is perineal prostatectomy. With this approach, a small U-shaped incision is made under the scrotum to remove the prostate. Because the surgery has less of an incision than the retropubic version, recovery is usually quicker.
There is also laparoscopic prostate surgery—multiple tiny holes are made in the abdomen and a surgeon uses a scope and video monitor system to navigate through the body to remove the prostate. This is minimally invasive, which usually means recovery is quicker.
Sometimes physicians choose to use radiation treatment to kill cancerous cells and tissue. With external beam treatment, radiation beams target cancerous areas. There’s also interstitial treatment, where radioactive “seeds” the size of rice grains are implanted in predetermined locations in the affected area. These seeds emit radiation in regulated doses, killing cancerous cells.
Another type of treatment can actually shrink the prostate in advance of surgery or radiation treatment for a better result.
Sometimes a physician can choose to go a completely different route called active surveillance. This involves monitoring the prostate cancer’s growth. Typically, this form of “treatment” is employed for men with small volumes of low-grade cancer who have some kind of ongoing health problem that precludes aggressive treatment options. Since prostate cancer can be slow growing, this method is usually employed in instances where surgery or radiation treatment might pose a greater risk—aggressive treatment would hamper remaining quality of life.
Regardless of the treatment option, the key to recovery is early detection. For men, an annual digital rectal exam at age 40 and a PSA screening at age 50 are recommended.
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