Prostate Cancer 101
December 25, 2003

Dear HouseCall Docs:
My wife keeps bugging me to get a prostate exam – what can you tell me about the exam? I’m 54 years old and have no real health problems.
Marvin – Mi Wuk, CA

Dear Marvin: It seems that either your wife cares very much about you and wants to keep you around for a long time, or she really doesn’t like you much and wants to see you squirm. Either way her suggestion is a very good one.

Prostate cancer is the second most commonly diagnosed cancer among men. Approximately 189,000 men in the United States will be diagnosed with prostate cancer this year, very similar to the breast cancer rate in women. Over 30,200 men will die from the disease this year. Interestingly, many men don’t even know what a prostate is, and certainly most don’t know what it does.

The prostate is a walnut-sized male reproductive organ located below the bladder and in front of the rectum. The prostate’s main role is to help produce a fluid that is the main component of semen. The prostate also makes a protein called prostate-specific antigen (PSA). PSA circulates in a man’s bloodstream and abnormal PSA levels can indicate possible prostate cancer. Other common prostate ailments include benign prostatic hyperplasia (BPH), enlargement of the prostate gland, and prostatitis, the general term for inflammation of the prostate gland.

One way to evaluate for an abnormality of the prostate gland is a digital rectal exam. While not a pleasant experience, this simple test is performed to detect lumps, enlargement or other problems with the prostate. At the same time, a stool sample can be tested for the presence of blood cells that could be an indication of an undetected cancer or disease of the intestines. It is currently recommended that any male over the age of 50 have a digital prostate exam as part of an annual physical exam. Men of African-American descent or with a direct family history of prostate cancer should be screened at a younger age- between 40 and 45.

The blood test that is commonly utilized to screen for prostate cancer is the PSA. A reading below 4 nanograms is considered normal, though that doesn’t entirely rule out the possible presence of cancer. A PSA level of 4 to 10 is considered abnormal and the likelihood of cancer is increased. A PSA reading greater than 10 nanograms indicates a strong likelihood of cancer. As with all health information, consult your doctor to discuss your individual conditions and the results of any tests.

The only good news about prostate cancer is that it is completely curable if it is detected early. So, make sure to get your prostate examined regularly, early detection can make all the difference.

If you have any health questions you would like answered please send them to us at docs@twainhartetimes.com. Until then stay healthy and happy.

Dr. Matt and Dr. Bob

Bob Uslander, MD and Matthew Personius, MD founded Sierra HouseCalls Medical Group, a local company providing at-home physician visits to the Tuolumne County area. Ph: 532-4287.

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