Prostate Disease

Can you discuss hormonal therapy to treat prostate cancer?

DEAR DOCTOR K: My doctor has proposed androgen deprivation therapy to treat my prostate cancer. Can you tell me about this treatment?

DEAR READER: Androgens are the family of male sex hormones that includes testosterone. When prostate cancer develops, testosterone contributes to the growth and spread of the tumor. Androgen deprivation therapy deprives cancer cells of this stimulation. Also known as hormonal therapy, it can be a powerful weapon in the fight against prostate cancer.

Do I need to take medication for BPH?

DEAR DOCTOR K: I have BPH. The symptoms don't interfere with my work or home life very much. My doctor says there are medicines that might reduce the symptoms, but I like to avoid taking medicines. What's your advice?

DEAR READER: Benign prostatic hyperplasia, or BPH, is the most common cause of prostate enlargement. As the name suggests, BPH is harmless; it does not lead to prostate cancer.

Are there any new screening tests for prostate cancer?

DEAR DOCTOR K: I keep hearing about problems with the PSA test. Are any new screening tests for prostate cancer in development?

DEAR READER: Prostate-specific antigen (PSA) is a biomarker. Biomarkers are chemicals that can reveal that something abnormal is happening in the body. PSA is a chemical released by cells in the prostate gland. It is released at relatively high levels when prostate cells turn cancerous. However, PSA also is released in non-cancerous prostate conditions.

My doctor advised active surveillance for my prostate cancer. What does this mean?

DEAR DOCTOR K: After an abnormal PSA test and biopsy, I have been diagnosed with early-stage, non-aggressive prostate cancer. My doctor advised active surveillance. What does this mean?

DEAR READER: Prostate cancer is the uncontrolled growth of abnormal cells in the prostate. This walnut-sized gland sits below the bladder, in front of the rectum, near the base of the penis. Prostate cancer is common, but it is not always dangerous. People are often surprised to hear "cancer" and "not dangerous" in the same sentence.

What can I expect during a prostate biopsy?

DEAR DOCTOR K: My last PSA test result was abnormal, so my doctor has scheduled a prostate biopsy. What can I expect? Is there anything I can do to make the procedure more comfortable and reduce the risk of complications? DEAR READER: An abnormal prostate-specific antigen (PSA) blood test result often leads to a prostate […]

Are there official guidelines for prostate cancer screening?

DEAR DOCTOR K: I've heard so many conflicting opinions about whether or not to get screened for prostate cancer. Are there official guidelines? What do they recommend?

DEAR READER: To say that prostate cancer screening has been controversial is an understatement. I spoke to my colleague Dr. Marc Garnick, clinical professor of medicine at Harvard Medical School, to hear his thoughts. The two ways to screen for prostate cancer are the digital rectal exam (DRE) and the prostate-specific antigen (PSA) blood test.

Why delay treatment for slow-growing prostate cancer?

DEAR DOCTOR K: I was recently diagnosed with prostate cancer. My doctor says my cancer is slow-growing and that we should just monitor it for now. Why not treat it right away?

DEAR READER: I know this will sound odd, but cancer is not always bad for your health. There are types of cancer that can cause no symptoms, that grow slowly (if at all) and that are unlikely to spread. There are types of cancer that you will never know you had. You will die with these cancers, but you won't die from them.

Does eating fish help prevent prostate cancer?

DEAR DOCTOR K: Does eating fish help prevent prostate cancer?

DEAR READER: You've certainly heard me encourage readers to eat plenty of fish, particularly fatty fish such as salmon and mackerel. That's because many good studies have found that people who eat fish frequently have lower rates of many serious diseases, including heart disease and several types of cancer. A recently published study from the Prostate Cancer Prevention Trial (PCPT) was described in the media as coming to the opposite conclusion. I don't agree, but to explain why, I first need to talk about the substances in fish that are thought to be beneficial for humans.

I was diagnosed with prostate cancer and now my doctor wants an MRI– what new information will the MRI provide?

DEAR DOCTOR K: I recently had a prostate biopsy and was diagnosed with prostate cancer. Now my doctor wants to do an MRI. Why? What new information will the MRI provide?

DEAR READER: I can understand why you're puzzled. A biopsy is the gold standard for diagnosing prostate cancer, so why do you need any other test?