Research Shows Promise for Enhancing Prostate Cancer Screening
- British actor Colin McFarlane, 61, is encouraging other men to overcome hesitancy when it comes to screening for prostate cancer. McFarlane was diagnosed with the disease in December 2022.
- Researchers with City of Hope have identified biomarkers linked to an increased risk of metastatic prostate cancer among men with West African heritage. They hope additional research will allow doctors the ability to predict which Black men are at higher risk of metastatic prostate cancer (cancer that spreads beyond the prostate).
- Although research is ongoing to enhance prostate cancer screening, SurvivorNet experts support standard testing methods such as a digital rectal exam and prostate-specific antigen (PSA) test. This test measures the level of PSA in the blood, and higher levels can indicate cancer.
- Patients are encouraged to ask their doctor about the risk level of their cancer, as well as its specific traits and features, to help determine the best treatment options.
Actor Colin McFarlane, 61, has been on a mission to promote prostate cancer screenings with added emphasis on Black men who are more likely to get the disease according to the National Cancer Institute.
A new study now suggests that biomarkers related to diabetes could lead to better prostate cancer screening for Black men. Although the new research may at some point give men and their doctors an added tool to combatting the onset of prostate cancer, physicians say that the standard-of-care recommendations for prostate screening are still crucial. These include traditional digital rectal exams and prostate-specific antigen (PSA) tests.
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British actor Colin McFarlane is known for his role in the Batman movie series “Dark Knight” but he’s also a staunch prostate cancer advocate. He was diagnosed after undergoing a routine prostate-specific antigen (PSA) test. This test measures the level of PSA in the blood, and higher levels can indicate cancer. Since his diagnosis, he’s promoted cancer screening.
Thankfully, McFarlane said he caught his cancer early. His cancer was considered “low risk” meaning treatment may not be necessary and only active surveillance is needed. This kind of surveillance involves regular testing every six months to monitor the prostate and check for any progression of the disease.
“[Men usually] don’t go to the doctor unless they’re in pain. It’s [prostate cancer] a silent killer, but it can be monitored and treated. A simple blood test could save lives,” McFarlane said.
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The new research conducted by City of Hope Comprehensive Cancer Center was a small clinical trial that identified “four metabolism-related biomarkers linked to an increased risk of metastatic prostate cancer” in men of West African heritage. When prostate cancer undergoes metastasis, it spreads beyond the prostate within the body.
Biomarkers are characteristics of the body that can be measured which includes things like your blood pressure, cholesterol, and heart rate. They can be obtained through a blood or urine test as well as a biopsy.
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Researchers focused on men with diabetes because they say this group has a “Significantly higher risk of developing metastatic prostate cancer, and this is exacerbated in Black men,” Dr. Sarah Shuck said in a news release. She is also the principal investigator of the clinical trial.
Amid their research, Dr. Shuck says, “We have identified genetic and molecular changes that can be developed into a tool to predict which Black men are at the highest risk of developing metastatic cancer.”
More specifically, methylglyoxal (MG), which is a byproduct of the metabolism, is elevated in people living with diabetes. When MG binds itself to DNA, RNA, and protein, scientists believe it may promote cancer or tumor growth because it creates instability in normal cellular function.
During the clinical trial, researchers found that men of West African heritage had lower amounts of MG in their blood.
“We think that the levels of methylglyoxal complexes are lower in [blood] circulation because they are accumulating in the tumor and driving tumor growth,” Shuck explained.
Researchers hope this discovery can help doctors “more accurately predict patients’ prognoses and equip scientists with more data as they work to design therapies that prevent prostate cancer from developing in the first place.”
While ongoing research shows promise to better screen for prostate cancer, there are currently tried and true means of screening that are still highly valued by SurvivorNet experts.
How Is Prostate Cancer Screened?
When you do get screened for prostate cancer, your doctor will run a few tests.
One of the tests is the PSA test, a simple blood test that screens for prostate cancer. It looks for larger amounts of protein-specific antigen (PSA) in the blood. An elevated PSA test does not always mean you have prostate cancer. It could also reflect that your prostate is enlarged which is common or it could signal an infection or inflammation.
Your doctor may also conduct a digital rectal exam (DRE) to check your prostate for lumps.
Depending on the results of these tests, imaging scans and a biopsy may be ordered.
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After tests are conducted, your doctor analyzes the results to give you a Gleason Score. This score ranges from 6 to 10. The higher the score, the more aggressive the cancer.
This score, along with your other test results, helps doctors determine if your cancer is “low risk,” “intermediate risk,” or “high risk.”
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Prostate cancer is the most common cancer in men. It starts in the walnut-shaped prostate gland, which is located between the rectum and bladder and produces the fluid that nourishes sperm. Fortunately, most prostate cancer is caught with screening examinations.
Prostate cancer does not always behave the same in every man it impacts. The cancer can be considered “low-risk” and can be slow-growing, and treatment might not be necessary. In other men, the cancer may grow faster or be more aggressive, requiring more immediate treatment. Because of this, there is some debate about screening.
The United States Preventive Services Taskforce recommends men at average risk between the ages of 55-69 years old should talk with their doctor about the pros and cons of prostate cancer screening. Most doctors agree that men over the age of 70 do not need screening.
SurvivorNet experts suggested that men consider factors like their family history, genes, and age when deciding whether, and when, to screen.
Symptoms of prostate cancer may include:
- Urinating more often
- Waking up in the middle of the night to pee
- Blood in your urine
- Trouble getting an erection
- Pain or burning when you urinate
- Pain in your back, hips, thighs, or other bones
- Unexplained weight loss
After testing and your risk has been established, your doctor will discuss possible treatment options. Treatment ranges from “active surveillance” usually for men with low-risk prostate cancer which again involves regular testing every six months to monitor the prostate and check for any progression of the disease.
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More aggressive treatment options include surgery and radiation therapy.
Surgery is an option for men with any risk group of prostate cancer that hasn’t spread outside of the prostate gland. The type of surgery most often used is called a radical prostatectomy.
During the procedure, the surgeon removes the entire prostate, along with some tissue around it, including the seminal vesicles that release fluid into the semen. Your doctor can perform this through a traditional open procedure with one large incision or several small incisions called laparoscopic surgery.
Surgery side effects may include erectile dysfunction and urinary incontinence. Fortunately, the side effects are usually temporary and there are ways to help you manage them.
Radiation therapy is often done when prostate cancer is caught early and confined to the prostate gland.
Questions for Your Doctor
If you have experienced symptoms associated with prostate cancer or have a screening coming up, here are some questions you may ask your doctor:
- If I have elevated PSA levels, what could be causing that besides cancer?
- How long will it take to learn if my PSA levels warrant further testing?
- What are the treatment options that are best suited for me based on my risk level?
- What financial resources exist to help me with the costs associated with treatment?
- How long will my potential treatment prevent me from working or continuing normal activities?