Men's Health - Prostate Cancer

The Movember Foundation is a charitable organization that leads a campaign during the month of November putting a spotlight on men's health issues.  You may have seen men growing a mustache for Movember - Mo for moustache.  The focus is primarily on three important issues that can shorten the lives of men - prostate cancer, testicular cancer, and mental health and suicide prevention.  Today, we'll start by talking about prostate cancer.  We will talk about the other issues over the next several weeks.

What is prostate cancer?

The prostate is a small organ that produces the seminal fluid that nourishes and transports sperm.  Cancer of the prostate is one of the most common types of cancer.  Some types of prostate cancer grow very slowly and do not spread to other areas.  These cancers may not cause any real harm.  However, there are other types of prostate cancer that are aggressive and can spread quickly to the bones and other areas of the body.

What causes prostate cancer?

Unfortunately, we don't really know what causes prostate cancer.  As with other cancers, we do know that it starts when cells within the prostate develop changes within their DNA.  These changes make the cells grow and divide more rapidly and live longer.  These cells form a tumor and sometimes cells can break away and spread to other areas of the body.  We are still doing research to find out why the DNA changes start in the first place.

What are the risk factors for prostate cancer?

• Age - Risk increases with age, being most common after age 50.
• Family history - Your risk is higher if you have a blood relative with prostate cancer.  Your risk is also higher if you have a strong family history of breast cancer, which may be related to genes that increase the risk of breast cancer (BRCA1 and BRCA2), which can also increase the risk of prostate cancer in men.
• Race - Black men have a greater risk of prostate cancer than other races.  Prostate cancer is also more likely to be aggressive in black men.  Unfortunately, we don't yet know the reason for this.
• Obesity - Research shows some mixed results but does suggest that obesity may increase the risk of prostate cancer.  Obese men who develop prostate cancer are more likely to have an aggressive cancer that is also more likely to return after treatment.
  

What are the symptoms of prostate cancer?

In the early stages, there may be no symptoms.  As prostate cancer becomes more advanced it may cause the following symptoms:

• Trouble urinating
• Decreased force of urine flow
• Blood in the urine or semen
• Bone pain
• Weight loss (without trying)
• Erectile dysfunction
  

Can prostate cancer be prevented?

You can reduce your risk of prostate cancer by making some healthy choices.  Here they are:

• Eat a healthy diet with a variety of fruits, vegetables, and whole grains.  
• Maintain a healthy weight.
• Choose healthy foods over supplements.  No studies have shown that any supplements reduce your risk of prostate cancer.
• Exercise most days of the week.  Exercise improves your overall health and helps you maintain a healthy weight.
• Know your family history.  Keep track of medical conditions that run in your family, including breast cancer, which may impact your risk of prostate cancer.
• Talk with your doctor about your risk of prostate cancer. 

Next week, we will talk more about prostate cancer, including the diagnosis and treatment.  

Here is a link to the Movember foundation

Movember - About Us - The Movember Foundation

If you have any questions about prostate cancer, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Screening Guidelines for Breast Cancer in Women

The screening guidelines for breast cancer differ depending on who is issuing the guidelines.  The U.S. Preventive Services Task Force (USPSTF), The American Cancer Society, and The American Society of Breast Surgeons, all have slightly different recommendations for screening.  The following recommendations are from the American Cancer Society.  We'll also talk today about some risk factors for breast cancer that you can control.

What are the screening guidelines for breast cancer in women?

Screening recommendations for women at average risk:

• Women between age 40 and 44 have the option to start screening with a mammogram yearly.
• Women 45-54 should get mammograms every year.
• Women 55 and older can switch to mammograms every other year, or they can choose to continue yearly mammograms.  Screening should continue as long as a woman is in good health and is expected to live at least 10 more years.
• All women should understand what to expect when getting a mammogram for breast cancer screening - what the test can and cannot do.
  

Screening recommendations are different for women at high risk for developing breast cancer.  There are several things that increase your risk for breast cancer, including your family history, certain genetic conditions, and having a history of radiation therapy to the chest.  If you are at high risk for breast cancer, your doctor may recommend that you start screening much earlier and may also recommend using a breast MRI in addition to a mammogram for screening.

How do you know if you are at high risk for breast cancer?

If you think that you might be at high risk for breast cancer, you should talk with your doctor about your concerns.  You and your healthcare provider can discuss your family history and other possible risk factors, and work through some different risk assessment tools to determine your overall risk.  Depending on your family history, your doctor may recommend that you meet with a genetic counselor and/or have genetic testing before making a final determination of your risk.

Can you lower your risk of developing breast cancer?

Absolutely!  There are some risk factors that you cannot change, such as your family history.  But there are several breast cancer risk factors that you can change by making some changes to your lifestyle.  Here are some of the risk factors that you can control:

• Drinking alcohol - Alcohol consumption is clearly linked to an increased risk of breast cancer, with the risk increasing with the amount of alcohol consumed.  Women who have one alcoholic drink a day have a small increased risk compared to nondrinkers, but women who have 2-3 drinks a day have about a 20% higher risk than nondrinkers.  
• Being overweight or obese - The link between weight and breast cancer is complex and may be different for certain types of breast cancer.  To lower your risk of breast cancer, you should try to stay at a healthy weight.
• Physical activity level - Regular physical activity reduces breast cancer risk, especially in women past menopause.  
• Not having children - Women who do not have children or who have their first child after age 30 have a slightly higher breast cancer risk overall.  

Please encourage your female friends and family members to have their breast cancer screening.  If you do not have insurance and cannot afford to pay for a mammogram, there are several organizations that may be able to help.  Your healthcare provider can help put you in touch with one in your area.

If you have any questions about breast cancer screening, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Breast Cancer Awareness Month

October is Breast Cancer Awareness Month. This is an annual event aimed at raising awareness about the impact of breast cancer. Although October is almost over, you still have the opportunity to help raise awareness in your family or community. Breast cancer that is detected early, when it is still small and has not spread, can be treated more easily and more effectively. Getting regular screening tests is the most reliable way to find breast cancer in its earliest, most treatable stages.

Let’s talk about some background first.

Breast cancer remains the leading cancer among women and the primary cause of mortality. According to The National Breast Cancer Foundation, every ten minutes a woman is diagnosed with breast cancer across the globe.

Breast cancers that are identified by screening tests are more likely to be smaller and limited to the breast. The size of a breast cancer, and how much it has spread outside the breast are some of the most vital factors in determining a woman’s response to treatment and ultimate survival odds.

What is a screening test?

A screening test in the medical sense is defined as a test or exam that is used to detect or rule out disease in a person who has no symptoms. If you have a symptom that prompts a test, such as a lump in your breast, any test done to evaluate that symptom is considered a diagnostic test, not a screening test. Screening tests are designed and recommended to find diseases when they are still too small to cause any symptoms that you would notice with the aim of improving survival and decreasing the burden of disease.

What are the screening tests used for breast cancer?

Mammogram

A mammogram is a special X-ray of the breast done with a low amount of radiation compared to other X-rays. Mammograms can often find breast changes due to cancer years before they would cause symptoms. Women who have regular mammograms are more likely to have breast cancer found early, are less likely to need aggressive treatment, and are more likely to be cured.

Studies have shown that regular annual mammogram screening of women with no symptoms of breast cancer has lowered the number of women who die from breast cancer by about 30 percent.

Mammograms are not perfect though; they do miss some cancers and they sometimes find things that look suspicious but turn out not to be cancer. They can result in additional tests to determine if something is or is not cancer.

There is a new type of mammogram called a 3D mammogram. It is more expensive than the standard (2D) mammogram, and it is not available at all breast imaging centers. It is now becoming more commonly available. This type of mammogram appears to lower the chance of needing to go back for additional tests and appears to find more cancers. It also appears to do a better job of screening on women with dense breast tissue.

Clinical breast exam and self-exam of the breast

Although this used to be routinely recommended, research has not shown clear benefit from regular breast exams, either by a health care provider or being done by women on themselves. However, women should be familiar with how their breasts normally look and feel and they should report any changes to a health care provider right away.

Although the research does not support a recommendation for routine breast exams in all women, that does not mean that they should never be done. For instance, if a woman is at high risk for breast cancer, after discussion with their doctor, they may decide that regular breast exams by their doctor is warranted. Some women prefer to do regular breast exams at home to keep track of how their breasts look and feel.

Next week we will talk more specifically about the recommended guidelines for breast cancer screening in women.

If you have any questions about breast cancer, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor