What is the prostate?
The prostate is a walnut-sized gland in men that is apart of the reproductive system.  The prostate sits low in the pelvis, below the bladder, in front of the rectum and the prostate surrounds the urethra. The prostate makes seminal fluid, the liquid in sperm that protects, supports and helps transport sperm.

What is prostate cancer?

Prostate Cancer begins when normal cells in the prostate begin to change and grow uncontrollably.  Some prostate cancers grow slowly and may not cause symptoms or problems for years while other prostate cancers are more aggressive and grow quicker, unfortunately, there is no way to predict how aggressive a cancer is before a biopsy.

Prostate cancer is the most commonly diagnosed, major cancer among all Americans. The incidence of prostate cancer increases with age. Some studies have shown an overall 2- to 3-fold increase in the risk of prostate cancer in men who have a history of this disease in their family. Family history is defined as prostate cancer in a brother, father, or an uncle. It is more significant if a family member was diagnosed with prostate cancer at a younger age (less than 60 years old). The incidence rate of prostate cancer is two times higher in African-American men than Caucasian men.

For more information about prostate cancer please visit Prostate Conditions Education Council's website at www.prostateconditions.org.

Prostate Conditions Education Council (PCEC) recommends a baseline prostate health assessment, including prostate specific antigen (PSA) and digital rectal exam (DRE), for all men at 40 years of age is beneficial for risk satisfaction.  Based on this initial baseline assessment, PCEC recommends that men establish a detection follow-up schedule as stated below.

• Men with a baseline PSA results greater than 1.5ng/ml or those with an abnormal DRE should be monitored and evaluated.  If the baseline PSA result is below 1.5ng/ml men and the DRE is normal testing can be every five years except for:
  
  • African-American men, those with a family history of prostate cancer, breast cancer, ovarian cancer, pancreatic cancer, presence of the BRCA gene, exposure to certain chemicals known to cause cancer or men over the age of 65 years.  These men should be monitored more frequently.

*PCEC does not advocate for screenings if a man’s life expectancy is less than 10 years.

Additional Information:

PCEC believes that all men should be informed of the pros and cons of early detection, diagnosis and treatment of prostate cancer.

PCEC encourages men to undergo a complete Men’s Health Evaluation and encourages a men’s health assessment which includes testing for: Testosterone, Total Triglycerides, Total Cholesterol, HDL, LDL, Glucose, PSA and new prostate cancer genomic markers and imaging tools as they become available. Men should be educated on the importance of a wellness prevention program including diet, exercise and weight.

Early detection programs are valuable for men who may not otherwise have access to or visit a physician on a regular basis.

Men must understand that screening does not diagnose cancer. Also, early detection of prostate cancer may find a cancer that does not need aggressive treatment and that the treatment options for prostate cancer often cause serious and life altering side effects.

A PSA blood test does not only look for cancer but also for other prostate abnormalities like enlarged prostates or prostate infections. A PSA of 1.5ng/ml is often used as a prostate health indicator of an issue with your prostate and it may be worth talking with a urologist.

PCEC will continue to support the development of personalized medicine through new markers for all conditions including the diagnosis and prognosis of prostate cancer through education and the utilization of our serum biorepository.

Genetic testing involves examining your DNA, the chemical database that carries instructions for your body’s functions. By taking a sample of your blood, saliva or tissue genetic testing can reveal changes (mutations) in your genes. Genetic testing plays a vital role in determining the risk of developing certain diseases, help with screening decisions and sometimes help identify the best medical treatment.

Genetic testing is voluntary and and with most tests it has benefits and risks that should be considered prior to having the testing done. A geneticist or genetic counselor can help by providing information about the pros and cons of genetic testing including the health, social and emotional aspects.

Myriad Genetics: The Prostate Cancer Quiz

Foundation Medicine

Who should have a genetic test for prostate cancer

Experts recommend that the following men consider genetic testing

• All men with prostate cancer from families meeting established testing or syndrome criteria for hereditary breast, ovarian or prostate cancers as well as lynch syndrome.
• Men who have two or more close blood relatives that have breast cancer, ovarian cancer, pancreatic cancer, prostate cancer or lynch syndrome.
• Men with metastatic castrate resistant prostate cancer should consider genetic testing.
• Men who have had tumor sequencing indicating mutations in cancer-risk genes may be recommended for germline genetic testing.

Why is genetic testing important for prostate cancer patients?

• Inherited genetic mutations exist in 12% of men with metastatic prostate cancer. The mutations are primarily in DNA repair genes such as BRCA1, BRCA2, and ATM.
• Having genetic testing may help you and your doctor make the best cancer screening and treatment plan for you. People who have a cancer gene mutation may need to start cancer screening earlier than usual, undergo screening more often, have additional screening for certain types of cancer and have a more aggressive treatment plan.
• Certain treatment options are available for men who have certain genetic mutations offering a more personalized treatment plan.
• Knowing if you have a cancer gene mutation can help your family members know if they may have a higher risk for certain cancers.

Germline versus Somatic Mutation

Germline Mutation
A germline mutation is an inherited mutation and can be passed from generation to generation. Cancer caused by a germline mutations is called inherited or hereditary cancer. More than 50 different hereditary cancer syndromes have been identified that can be passed from one generation to the next.

Somatic Mutation
Somatic mutations occur from damage to genes in an individual cell during a person’s life. Somatic mutations are not found in every cell in the body and they are not passed from parent to child. Somatic mutations may occur over time and change during the course of treatment.

There are many resources avaialble for men and their caregivers seeking additional information about prostate cancer or looking for support groups to talk to near you.

www.prostateconditions.org

www.menshealtheducationcouncil.org