Check Up 13: Getting screened for prostate cancer

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Check Up 13 Prostate cancer
Check Up 13

INDIANAPOLIS (WTHR) - Prostate cancer is the third leading cause of cancer death for men in the United States.

Studies show 1 in 7 men in the U.S. will be diagnosed in their lifetime. Men are at a higher risk if they are African American and if their father or brother is diagnosed with prostate cancer. The older a man is, the greater his risk of developing prostate cancer.

The screening for prostate cancer includes a blood test measuring protein to generate a PSA score and a digital rectal exam. The exam is the part of the screening that men tend to avoid. Both tests are free for qualified men for Check Up 13 this month.

"Both [tests] are important. There is probably 5-10% of cancers that can present with a normal PSA but an abnormal rectal exam, so if you just did the PSA, you would still miss some cancers," says Dr. Scott Farnham with Urology of Indiana.

Larry Randel of Zionsville, lost his two older brothers to cancer, and so he made sure he stayed up on all recommended health screenings, like the prostate exam.

"It's a no brainer" Randel said. "It's a load off your shoulder, once you walk out and know you are ok!"

His wife of 51 years Martha, is grateful she didn't have to nag Larry to stay current on his screenings.

"Fortunately, I have a great husband. He was very willing and wanted to have good health he wants to live a long time to enjoy family and our grandchildren," Martha said.

For years, doctors tracked Larry's increasing PSA numbers and noted the exams revealed an enlarged prostate. But when Larry noticed blood in his urine, he had a premonition and called his doctor immediately.

"There are two words that men don't want to hear or really discuss prostate and cancer, but you put the two together the same sentence then you got issues," Larry said.

Doctors used the information from his PSA history, and symptoms to order a biopsy.

"They actually took eight samples and of the eight, three of them came back cancerous," Larry said.

After discussing the biology of the cancer and treatment options, Larry opted to have Dr. Farnham perform a robotic surgery to remove the prostate.

"We see all different biologies related to prostate cancer. I think there is a bit of a misunderstanding out there that all prostate cancer is slow growing," said Dr. Farnham. "There are some slow growing tumors, but there are also some more aggressive tumors and we see the whole spectrum. Do you have a turtle that is moving more slowly, or a rabbit or a bird that has kind of flown the coup at the time of diagnosis?"

Dr. Farnham encourages all men to get a baseline screening at age 40, and before that if they have a family history of prostate cancer and/or are African American.

"One of the things that's been challenging the last few years is there has been some controversy about prostate cancer screening. There are national guidelines through the US Preventative Task Force that have come out and there has been a mixed message… to primary care doctors and patients because there has been a risk of over-treating," Dr. Farnham said. "It really gets back to risk stratification for balance. You don't want to over screen and detect too much low risk cancer and lead to over-treatment but you also don't want to miss the important biological active cancers," he added. "So that gets back to that shared decision-making process with the patient and the doctor."

Now, post-surgery, Larry says he is fully functional. Dr. Farnham says Larry is cancer free and his prognosis is great.

Dr. Farnham's advice is to start the conversation with your doctor, and get screened regularly so physicians can compare your test results over time. "There are five risk categories for prostate cancer: very low risk, low risk, intermediate, high, and very high risk. A basic principle is certainly the sooner you can detect it the better chance to treat with curative intent. It's harder to deal with something that has progressed much further. You just have fewer options and so you have lost a window of opportunity for treatment.."

"Don't worry about the modesty. It's a prostate exam, it takes 15-30 seconds. You've got 30 seconds or a full lifetime. It's a pretty easy decision to make" Larry said.

If you would like to get screened, Check Up 13 and St Vincent are offering a free prostate exam and blood test for patients who are 40 and older and who haven't had a screening in the past year.

To register, call the hotline 8AM to 7PM Wednesday, September 13, 2017. Or register online here.

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