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Men-Celebrate Men's Health Month. Learn About Prostate Health

June 18, 2013

New guidelines for prostate cancer screening are announced

June is the month we celebrate fatherhood. It's also Men's Health Month - an event encouraging men and boys to learn more about their health, get regular medical information and advice, and seek early treatment when they are sick or injured.

One important issue for men is prostate health, especially as they grow older. More than 30 million American men suffer from prostate conditions that negatively affect their quality of life, according to the Men's Health Network, a national non-profit organization that supports prevention and health education for men.

Most common cancer

Prostate cancer is the most common cancer in men. The CDC reports, in 2009, more than 206,000 men were diagnosed and more than 28,000 died from prostate cancer.

"With prostate cancer, most men don't experience symptoms in the early stages, when it is most treatable," said Mark Saleh, M.D., a board certified urologist with Washington Township Medical Foundation, who is also on the medical staff at Washington Hospital.

"That's why screening is so important," he added.

Screening is a way of looking for disease before symptoms appear. Prostate cancer screening is done by two common tests: a digital rectal exam by a physician and the prostate specific antigen, or PSA, test. This test measures a man's blood for the level of PSA, a substance made by the prostate. In general, the higher the PSA level, the more likely the man has some problem with his prostate.

Change in guidelines

"The big news for men's health is that the American Urological Association has just changed its recommended guidelines on when and how often men should have their PSA tested," stated Dr. Saleh.

Until recently, it was generally accepted that men between age 50 and 75 should have their PSA screened annually. Last month, the Association changed the recommendation, limiting testing to between ages 55 and 70. In addition, men of average risk should be tested every other year, rather than annually.

"The Association has also created stricter guidelines for when a biopsy of the prostate should be done," said Dr. Saleh. "It now states that before the decision to do a biopsy is made, the PSA level should be higher than previously recommended."

In addition to cancer, there are a number of other factors, such as a man's age or race, that may contribute to an elevated PSA level. These include certain medical procedures, some medications, or an enlarged or infected prostate.

In announcing the new guidelines, the Association stressed that the recommendations apply to men of average risk for prostate cancer. Men of any age who are at high risk, such as those with a family history of the disease or who are of African-American decent, should talk with their doctor about when to be screened.

The Association asserted that decision-making about prostate screening should be shared between a man and his doctor, and it should take into account the man's values and preferences.

More frequent problem

Dr. Saleh emphasized that men should be vigilant about prostate cancer screening at the appropriate age and the recommended frequency. However, they should also be aware that urinary symptoms that occur as they get older are more often due to an enlarged prostate, a condition that is also called benign prostatic hyperplasia (BPH).

More than half of men in their 60s and as many as 90 percent who are 70 or older have symptoms of BPH, according to the Men's Health Network.

The prostate, a walnut-sized gland that is part of a man's reproductive system, continues to grow throughout most of a man's life. The enlargement usually does not cause problems in men younger than 40.

As the prostate enlarges, it begins to press against the urethra, the tube carrying urine out of the bladder. This can cause the tube to narrow, leading to more frequent urination, a weak urinary stream, and an inability to empty the bladder, symptoms most often associated with BPH.

"Prostate enlargement is as common a part of aging as gray hair," states the National Institutes of Health (NIH). "As life expectancy rises, so does the occurrence of BPH."

The NIH reports that, in one recent year, men visited their physician 4.5 million times for BPH.

Learn more

To learn more about Men's Health Month, go to www.menshealthmoth.org. For more information about Washington Township Medical Foundation, go to www.mywtmf.com, and for more about Washington Hospital, visit www.whhs.com.

To find out more about prostate cancer, benign prostatic hyperplasia and prostate screening, visit the Web site of the American Urological Association at www.auanet.org or go to www.cdc.gov (U.S. Centers for Disease Control) or www.nih.gov (National Institutes of Health).