Cancer Journey

What You Need to Know about Prostate Cancer Screening from a 4-time Cancer patient

Learn what’s involved in screening and how an early diagnosis can make all the difference

By Katie Ressler

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With a long history of fighting cancer – including testicular, kidney and thyroid cancers – the possibility of prostate cancer lingered in the back of the mind of Keith R., of Queen Creek, Arizona. After all, it is the most commonly diagnosed cancer in men, after skin cancer.

“Any time I had some type of screening or medical test, the possibility of prostate cancer appeared in my thoughts,” Keith says.

What is involved in prostate cancer screening?

According to Kevin Tulipana, DO, Chief of Staff at Cancer Treatment Centers of America®, Tulsa, getting screening for prostate cancer is very simple.

“We no longer recommend the digital rectal examination for prostate cancer screening; rather, a simple blood test called a prostate-specific antigen (PSA) is the preferred method of screening,” he says.

When to begin screening for prostate depends on a number of factors. Dr. Tulipana explains:

The time to start screening depends on a patients risk of developing cancer and discussion with their physician.  Generally, an average-risk man should discuss the benefits and risks of prostate cancer screening beginning at 50 years of age.  Black men and men with a first-degree relative who had prostate cancer before 65 years of age, should begin this discussion at 45 years of age.  Men who have a BRCA genetic mutation should begin this discussion regarding benefits and risks at 40 years of age. Some experts recommend screening every year, while others will recommend every two years.

For Keith, screening came up during a follow-up appointment for his kidney cancer. His urologist recommended screening Keith for prostate cancer with a PSA test due to his age and his cancer history.

When the results came back, he was informed that his results were high for an African American, and his physician decided to biopsy his prostate as a next step. The biopsy showed cancer cells were in three of four quadrants.

Turning to Faith

“I was not prepared for another diagnosis. I was very concerned, more than the other times I had cancer,” Keith says. “I was thinking, how many times will I be diagnosed with cancer and survive. So, I had to get prepared. I had to leave it in God’s hands.”

In addition to being an instructor of university success and also health administration at Grand Canyon University, Keith is also an ordained minister and had received training through the CTCA® program, Our Journey of Hope®, which provides pastors and ministry leaders with the tools, training and support to raise up cancer care ministries in their churches and communities.

“When I received that fourth diagnosis, I thought back to a training I went through called Our Journey of Hope. Although I was under care elsewhere at the time, I was impressed with the integrative approach that CTCA® offered patients,” Keith recalls. After speaking with Pastor Jeff at CTCA Phoenix, he decided to visit CTCA for an evaluation.

Treatment for Prostate Cancer

Treatment options for prostate cancer depend on a number factors, including stage, type and progression of the disease. The most common treatments for prostate cancer include:

  • Chemotherapy
  • Hormone therapy
  • Immunotherapy
  • Radiation therapy
  • Surgery

In addition to these treatment options, active surveillance, often called watchful waiting, may be an option.

For Keith, screening led to an early enough diagnosis that surgery was a viable treatment option. His physician, Farshid Sagedhi, MD, provided a care plan, which included a robotic prostatectomy.

“I was able to catch it early to where I can have a decent quality of life, so I encourage screening,” Keith explains. “I discuss all aspects, from my initial reaction to having cancer for the fourth time, the active surveillance, the visits at CTCA, the excellent care I received, the surgery, and the journey of healing.”

Early Screenings are Key

Early stage prostate cancer usually causes no symptoms. More advanced prostate cancers may cause symptoms, including:

  • Problems with urination
  • Blood in urine or semen
  • Erectile dysfunction
  • Pain in the hips, spine or ribs, where cancer may have spread to bones
  • Weakness or numbness in lower extremities, or loss of bladder or bowel control from cancer pressing on the spinal cord.

Because most men have no symptoms, it’s important to begin discussions with primary care physicians to determine if and when prostate cancer screening is appropriate.

“Screening for cancer is very important as it can find cancers early when treatment is likely to be more successful. Although there is not a consensus regarding prostate cancer screening, it is important to discuss this and other screening tests with your primary care provider so that you can make an informed decision regarding your health,” says Dr. Tulipana.

While the PSA is the recommended method for screening, it’s important to remember that an elevated PSA does not mean that cancer is present.

“A man with an elevated PSA does not necessarily have prostate cancer. There are many things, such as an infection or injury that may transiently raise PSA.  At the same time, a low PSA does not mean that you don’t have prostate cancer,” says Dr. Tulipana.

If you receive results that show an elevated PSA, your physician will often recommend that you follow-up with a urologist to discuss options. An elevated PSA usually required further evaluation, possibly including a repeated PSA testing, imaging or a biopsy.

Given his long history with cancer, Keith continues to use his story to encourage screening, especially for prostate cancer.

“I use my story. Because of screening, I am here today living and enjoying a good quality of life. I tell them I want their story to be better than my story,” he says. “I have taken on the fight, personally, to encourage good health in men and women.”