PROSTATE CANCER GLOBAL PREVALENCE - 2012
cases recorded. cancer when it is still within the prostate gland. The term we use is organ confined prostate cancer.”
Dr Selvalingam adds that men without a family history can go for screening after the age of 55 but those with a family history should screen by age 50. However, he also stresses that prostate cancer is very unlike other cancers.
“There are many variants to it and there are many insignificant cancers in the prostate which do not affect men throughout their lives. These insignificant cancers are not what we want to detect. We want to catch the significant prostate cancers, those which are going to affect the man in his lifetime.”
SCREENING TOOL
However, at present there’s isn’t an effective screening tool which can make a distinction between these two types of cancers. Right now, most men go for the PSA or Prostate Specific Antigen test.
Dr Selvalingam explains that the PSA test is not specific for prostate cancer so if the result is abnormal, it doesn’t mean the individual has prostate cancer. But doctors would recommend that he have a prostate biopsy done to confirm whether there is cancer.
“Sometimes, the PSA test may actually pick up the insignificant cancers but men live in anxiety waiting for the results of their biopsy because the test result was abnormal.” It is for these reasons that men who decide to go for the PSA test should have a prior discussion
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and the lowest in with their doctor instead of just going to a lab and having it done. They need to be fully informed of what the test entails, that it is not a perfect screening tool and what further steps may be necessary if results are abnormal.
Dr Selvalingam says besides picking up a lot of insignificant cancers, the PSA reading of an individual may also be raised or abnormal if the man had sexual intercourse before the test, if his prostate is big or he has some benign condition of the prostate like prostatitis, an inflammation of the prostate.
The test results may even be abnormal if the man has a urine infection. Many factors can influence the outcome of the test and patients must be informed of this.
Where treatment options are concerned, there are currently many different options for those diagnosed with prostate cancer including surgery, chemotherapy, radiation and hormone therapy and doctors will discuss these options with the patient and recommend what is best given his condition.
Dr Selvalingam says in some cases doctors may decide to do nothing. If for example, what was detected was an insignificant prostate cancer, then doctors will do what’s called “active surveillance”, where they monitor the individual but don’t initiate treatment yet.
Over time, if there is progress in the cancer, then treatment is initiated.