My recent column on ovarian cancer was for the women. This week, it’s for the guys.
Prostate cancer is one of the most common cancers in American men. More than 1 million men in the U.S. live with the diagnosis of prostate cancer, and many more men have it and are unaware of it. It is estimated that the disease will affect one out of six men in our population.
The majority of men with prostate cancer are in their 70s or 80s. Many of them are not aware of their cancer and will likely die of other illnesses before they ever succumb to prostate cancer.
The prostate gland is a walnut-shaped gland in men that is located between the bladder and the base of the penis and produces fluid to help transport sperm. In many cases, the cancer is very slow-growing and is confined to the gland itself — it may not spread for years or even decades.
Unfortunately, sometimes the cancer can be more aggressive and spread rapidly. This is especially true when it’s diagnosed in younger men. As with all cancers, the sooner it is detected, the better chance of a cure.
Prostate cancer usually does not produce noticeable symptoms in its early stages, so many cases of aren’t detected until the cancer is found during a routine exam or after it has spread.
When urinary symptoms do occur, they include the following:
• A weaker urine stream
• An intense urge to urinate
• Frequent urination
• Blood in urine
• Lower-abdominal pain
There are several main risk factors to keep in mind:
• Old age: It’s rare before age 40, but your risk increases with every passing decade.
• Ethnicity: Prostate cancer is more common in black men.
• A family history of prostate cancer, especially in a father or a brother
• A high-fat diet
• Treatment with the hormone testosterone
Regardless of symptoms or risk factors, though, men need to be screened for prostate cancer.
One method of screening is the PSA blood test. I advise that men follow the recommendations of the American Urological Society and have their first PSA test at age 40. If the result is low, then — with the advice of your doctor — the next test would be at age 45 and then once a year thereafter.
Of equal or even greater importance is the rectal exam. Although most men tend to shy away from this exam, it is extremely important in diagnosing prostate cancer and has saved many lives.
The exam is slightly uncomfortable but is quick and simple. The doctor will feel the surface of the prostate gland through the rectal wall and will check the surface of the gland for any abnormalities, such as bumps, hardness and enlargement.
The bottom line: Men need to talk with their doctor about prostate screening by age 40. I understand the reluctance that many men may feel when they contemplate having this recommended yearly exam, but I can’t emphasize enough the importance of routine prostate screening, which can prolong and enhance a man’s life.
• Terry Hollenbeck, M.D., is an urgent care physician at the Palo Alto Medical Foundation Santa Cruz in Scotts Valley. He invites readers to view all his previous articles on his blog, Valley Doctor. Information in this column is not intended to replace advice from your own health care professional. For any medical concern, consult your own doctor.

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