Magnetic Resonance Imaging (MRI) Instead of a Prostate Biopsy

For several decades I have ordered PSA testing as a screening test for prostate cancer, the most common cancer in middle aged men and the second most cause of death, following lung cancer, in men.  The PSA test is now controversial as a result of the U.S. Preventive Services Task Force recommended five years ago that men forgo the test because the blood test led to too many inaccurate prostate biopsies, which in turn resulted in diagnosis  of insignificant prostate cancer or cancers that were so slow growing that no treatment was required and also resulted in many men who received treatment and had side effects and complications that significantly impaired their quality of life.

Now, however, there is true progress in prostate cancer detection, bringing a new era of minimal intervention yet maximum accuracy of diagnosis and treatment. The single most important factor in this change is the addition of multiparametric MRI (mpMRI) before having a prostate biopsy. There is compelling research-based evidence, both in the U.S. and abroad, that mpMRI can help determine if a biopsy is not yet necessary. This means sparing men from conventional TRUS-guided biopsy that has a discouraging track record of inaccuracy. On the other hand, if mpMRI detects a suspicious area, a real-time MRI guided targeted biopsy facilitates pinpoint diagnosis and treatment matching.

According to a newly published article, “Prebiopsy MRI followed by targeted biopsy” appears to have the ability to overcome the limitations of the standard 12-core template [biopsy]. The authors of the review point out that both the American Urological Association and the Society of Abdominal Radiology have confirmed the utilization of MRI prior to biopsy.

I hope you have found this blog helpful.  If you have any questions about managing your elevated PSA, please let me hear from you.

The Skinny On Screening for Prostate Cancer

Prostate cancer is the second most common cancer among men (after skin cancer), according to the American Cancer Society. It is the second most common cause of death in following lung cancer and causes nearly 30,000 deaths annually in the United States.  The good news is that often prostate cancer can be treated successfully, especially when caught in its early stages.   More than 2 million men in America count themselves as prostate cancer survivors, according to the American Cancer Society.

At the present time screening for prostate cancer is controversial in the medical profession.  There are physicians who believe that testing all men for prostate cancer outweighs the benefit because it may find some very slow growing cancers in some men that could be left alone without any negative consequences. My personal opinion is that prostate cancer screening should be done but requires education and a decision made between doctor and patient.

My belief is that if prostate cancer is detected early, it has a favorable  prognosis. If men ask me what are the early signs of prostate cancer, the answer is that there are NO early signs of prostate cancer when it is confined to the prostate gland.  That is why men need to have an examination or the digital rectal examination and a PSA test.

Risk factors help determine who should be screened when

The protocol starts by evaluating men for their risk factors for developing prostate cancer. Risk factors include: age (after age 50 risk of prostate cancer rises rapidly); race (men of African-American and Caribbean descent are at higher risk); and family history (men who have a father, brother, or uncle with prostate cancer are at a higher risk of developing prostate cancer and should be screened on a regular basis) Men should be screened every year until they reach age 70 or 75. For most men who reach age 70 and all their screening tests are normal, the chances of their developing a cancer that would impact their well-being or their longevity is really low.

Managing the elevated PSA test

If your screening detects a possible cancer, your doctor will order a biopsy. This is done in the office under a local anesthesia and takes 10-15 minutes.  If the biopsy detects prostate cancer, then the next step is to determine the aggressiveness of the cancer or how likely it is to spread or grow.  For men with low-risk tumors that are not going to put their health or longevity at risk, I will often recommend surveillance, which means regular testing of the PSA and a follow up biopsy in 12-18 months.  As long as the PSA remains stable and there is no evidence of escalation of the cancer, then these men can be safely followed and only treated if the cancer appears to be growing or the PSA is steadily increasing.  Men with more aggressive tumors may need surgery and\or radiation. You and your doctor will make the best treatment decisions for you together.

Bottom Line:  Prostate cancer is a common cancer and can easily be diagnosed with prostate cancer screening.  Not all men need to be screened, but if you are between 50 and 70 years of age, speak to your doctor about the benefits of screening and make an informed decision if screening is right for you.

PSA Testing for Prostate Cancer-To Screen or Not to Screen That is the Question

Today, nothing is more confusing for men than the concept of screening for prostate cancer.  Prostate cancer is the second most common cancer in men, following lung cancer, and there are 250,000 men each year diagnosed with prostate cancer and causes nearly 30,000 deaths a year.  About one in seven men will be diagnosed with prostate cancer during his lifetime.

But some prostate cancers develop slowly, and, as the disease is more common in elderly men, most men with prostate cancer die with it and not from it. Thus, screening, diagnosis and treatment of the disease are controversial.

There is no consensus about prostate cancer screening as early diagnosis can be associated with very bothersome side effects such as erectile dysfunction and urinary incontinence.  Also screening has not been universally shown to increase survival or decrease the death rate from prostate cancer.  This article will discuss the pros and cons of PSA screening for men.

Men who opt for screening undergo a digital rectal exam and a blood draw to measure a chemical called PSA or prostate specific antigen. This level of PSA can be increased in men with prostate cancer. Other conditions may cause the increase in the PSA such as benign enlargement of the prostate gland and prostate infections.

The best way to detect an early potentially deadly case is to collect yearly PSA tests over three to five years so trends can be assessed.

I like most other urologists are concerned about over treatment of prostate cancer — in other words, being too aggressive in using surgery or radiation when a small amount of potentially slow-growing cancer is found on a biopsy.

The federal government has also become concerned about this issue. A large medical research trial called the Prostate Lung Colorectal and Ovarian (PLCO) Cancer Screening Study released results from 2009 showing no benefit from screening for prostate cancer when comparing a large group of unscreened men to a large group of aggressively screened men.

Researchers across the country are assessing the effects of the USPSTF recommendations on prostate cancer mortality since 2012. In a recent study from Northwestern University in Chicago, researchers found a significant increase in the cases of advanced prostate cancer already spread to other parts of the body from 2004 to 2013. As a result we could be missing serious cancers because of decreased screening.

Prostate cancer also has a hereditary predilection and men with a father, brother, cousin, or uncle should consider having screening around age 40.  This also applies to African-American men who have a greater risk of prostate cancer than Caucasian men and should also have testing after age 40.

My best advice is to ask your doctor\urologist about the decision to undergo prostate cancer screening.

Tomatoes and Not Potatoes May Help Prevent Prostate Cancer

For many years I have been focused on nutrition and various urologic diseases, especially prostate cancer.  Although the relationship between prostate cancer and diet is certainly a consideration, the use of tomatoes may be one of the strongest preventive options a man can take to avoid prostate cancer.

There are many health advantages of eating more tomatoes, which includes a lower risk of prostate cancer and other cancers as well. While the good news is Americans eat more tomatoes and tomato products than any other non-starchy vegetable, about 90% of adult men fail to consume the 2.5 cups of vegetables per day recommended by the 2010 Dietary Guidelines for Americans.

Tomatoes contain a high antioxidant content, specifically lycopene. Lycopene has been the subject of many research studies regarding its protective effect against prostate cancer.

In men with prostate cancer, lycopene supplementation has been shown to be safe and tolerated well in doses up to 120 mg per day for up to one year. Toxicity is generally very mild, with diarrhea as a possible side effect at very high doses.

There appears to be a protective effect of tomatoes and tomato products on the prevention of prostate cancer as well as improvements in biomarkers of disease status, including the PSA levels.

A unique characteristic of tomatoes is that unlike the nutrients in other fresh fruits and vegetables, lycopene is more bioavailable after tomatoes are cooked and processed. This fact opens up even more possibilities for individuals to enjoy the benefits of lycopene.

According to the US Department of Agriculture National Nutrient Database for Standard Reference, ½ cup of tomato paste contains 18.84 mg of lycopene, while an equal amount of tomato sauce has 17.12 mg, spaghetti sauce has 15.82 mg, and tomato juice has 10.88 mg of lycopene.  One-half cup of raw tomatoes, however, contains only 2.32 mg of lycopene. Non-tomato products that contain lycopene include watermelon (1/2 cup has 3.44 mg) and grapefruit (1/2 fruit contains 1.75 mg).

More recent hypotheses have looked at the advantages of whole tomatoes, which are excellent sources of vitamins A and C, fiber, and potassium, and identified other protective elements beyond lycopene. Vitamins A and C are potent antioxidants, while fiber has been shown to reduce cholesterol, and potassium is helpful in lowering blood pressure and possibly reducing bone loss.

Experts in nutrition and cancer note that the preponderance of evidence suggests that consumption of whole tomatoes and tomato products should be preferentially recommended because of greater consistency of documented positive outcomes with the whole tomato and the concomitant supply of other important essential nutrients.

Given that tomatoes and tomato products are already dietary favorites, increasing their consumption can achieve several goals, including reduction in the risk of prostate cancer and other diseases, and helping Americans achieve the recommended daily intake of 2.5 cups of vegetables.

Bottom Line: Prostate cancer is the most common cancer (besides skin cancer) in men and the second most cause of death in men following lung cancer.  Men can be easily diagnosed with a PSA test and a digital rectal exam.  Man can also decrease their risk of prostate cancer by consuming lycopene, an antioxidant, which is plentiful in tomatoes.

PSA Testing-What Every Man Needs to Know

Prostate specific antigen is a simple blood test that can be a metric for prostate health.  It is a good screening test for prostate cancer.  This blog will discuss the PSA test and what you need to know to make a decision to obtain this common test.

Let’s start by reassuring men that having an elevated PSA level does not necessarily mean you have prostate cancer.

PSA is also likely to be increased with benign enlargement of the prostate gland as well as prostate infections or prostatitis.

It is important to emphasize that the PSA test is not a specific prostate cancer test, but it is a vital first step in screening for the potential presence of cancer.

The other factors that can cause PSA levels to rise:

• Age: PSA levels can increase gradually as you age
• Prostatitis: Inflammation of the prostate gland, due to infection or some unknown cause
• Benign prostatic hyperplasia (BPH): This condition refers to an enlarged prostate.  More prostate means more cells making prostate specific antigen, increasing the potential for an elevated PSA.
• Urinary tract infection: can irritate and inflame prostate cells and cause PSA to go up
• Medications: Some medications like Proscar, Avodart, or Propecia can falsely lower your PSA.  This too is important to remember.  If you are on any of these medications, talk to your doctor.  The general rule of thumb is to double your PSA for an accurate score.
• Sex/ejaculation:  This can cause a mild elevation in the PSA, but should return to normal after a few days. That is why I usually recommend that men refrain from sexual intimacy for 48 hours prior to PSA testing
• Prostate trauma: Anything that causes direct trauma to the prostate such as riding a bike, having a catheter inserted into the blader, a prostate biopsy, or a cystoscopy which is a look using a lighted tube through the urethra (tube in the penis that transports semen and urine) can increase the PSA temporarily.

A PSA level of less than 4.0 ng/mL is normal, while changes of more than 2.0 ng/mL over the course of a year could be an indicator of the presence of prostate cancer.

I point out that there is a familial or inherited basis of prostate cancer and also an increased risk of prostate cancer in African-American men.  In these men who are are at a greater risk of prostate cancer, I suggest annual testing with a digital rectal examination and a PSA test after age 40.  For all others, I suggest testing begin at age 50.

For men who have an elevated PSA test, then a discussion with the doctor about repeating the test in a few weeks or proceeding to an ultrasound examination and a prostate biopsy is in order.

Bottom Line: PSA testing is a non-specific test used to screen for prostate cancer.  Not all elevations of the PSA test indicate cancer.  Further testing and close monitoring as well as a prostate biopsy is in order.  For more information, speak to your doctor.

Preventive Health For All Men

Do you know that most men spend more time taking care of their cars or planning a vacation than they do taking care of their health?  In the U.S., women live 5-7 years longer than men.  I believe one of the reasons is that women seek out regular medical care throughout their entire lives.  They see a obstetrician during child bearing years; they get regular mammograms; they obtain routine PAP smears and other preventive health measures for their entire lives.  Men, on the other hand, stop seeing a doctor around age 18 and never see the inside of a medical office until middle age.  During that time they can have high blood pressure, elevated cholesterol levels, diabetes, and prostate diseases.

But there are some things men, in particular, should keep in mind when it comes to maintaining their health:

Heart disease and cholesterol

According to the Centers for Disease Control and Prevention, about 200,000 people die each year from preventable heart disease and strokes, with men being significantly more at risk than women.

Men should begin screenings for these issues in their mid-30s.

Annual health examinations should begin at around age 50.  This should include a test for anemia, a cholesterol level, a chest x-ray if the man is a smoker, a PSA test for prostate cancer, and a blood pressure determination.

For those men with an elevated cholesterol level, they can lower the level by adhereing to  a healthy diet consisting less heavy in red meats and carbohydrates, and limiting alcohol consumption, i.e., 2 drinks\day. Men of all ages should also continue to stay physically active by incorporating aerobic activities, i.e., any activity that increases the heart rate for 20 minutes 3-4 times a week, into their lifestyle, as well as strength training.

Prostate health

There is some debate among health care professionals about when men should begin screening for prostate cancer. The U.S. Preventive Services Task Force and the CDC recommend against screening unless men begin experiencing the symptoms associated with prostate cancer. These include frequent urination, especially at night, pain during urination and difficulty fully emptying the bladder.

Prostate screening can begin earlier in life, around age 40, if there is a high risk for prostate cancer, such as family history, or bothersome lower urinary tract symptoms.

Testosterone

As men age, lowering testosterone levels can become another area men should monitor.  Significantly low testosterone levels can predispose a man to low bone mineral density with subsequent bone fractures, erectile dysfunction (impotence) and low energy levels.

Testing for testosterone levels is done through a blood test.

Bottom Line: these are the minimal preventive care that all men should consider around age 30-40.  Remember if it ain’t broke don’t fix it, may apply to your car, but not to your body.  You need to take preventive measures with your body just as you do with your automobile.

Prostate Biopsy Negative? What’s Next?

There are over 1 million men who have a prostate biopsy each year.  Many of the biopsies are negative.  What can a man do who has an elevated PSA level and a negative biopsy to be certain that he doesn’t have prostate cancer and avoid having a second biopsy?

Lots of controversy surrounds the standard PSA (prostate-specific antigen) screening test for prostate cancer, which is unreliable and not specific for the disease. This uncertainty has prompted many men to ask, “Is there a better test for PSA?” Fortunately, there are options which, while they don’t replace the current PSA test, can provide significantly more reliable, actionable information.

The PSA test involves a blood draw and measuring the level of the blood protein, prostate specific antigen. Currently, men whose PSA test levels are between 4 ng/mL and 10 ng/mL typically are told they should consider getting a prostate biopsy. However, an elevated PSA can be caused by many different benign conditions such as benign enlargement of the prostate gland, a prostate infection or simply lifestyle habits, which means a biopsy would be an unnecessary invasive procedure.

Why we need more accurate testing?

Approximately 1.3 million prostate biopsies are performed annually, and less than one third of them reveal cancer. While that sounds like good news on one hand, on the other hand it means that two thirds of those biopsies may not have been necessary and/or these men have negative biopsy results but other clinical risk factors for prostate cancer such as a family member who has prostate cancer or being an African-American man who have a slightly greater risk for prostate cancer than a Caucasian man.

If you have been in this situation, you probably know how frustrating and confusing it can be. What should you do? Have a repeat biopsy or choose to have more tests? The uncertainty of having a hidden prostate cancer can lead men to get repeat biopsies, which can be associated with an increased risk of infection, hospitalization, emotional trauma, and significant costs.

Fortunately, some progress is being made in the realm of better testing for prostate cancer and in determining whether a prostate biopsy is necessary. In this blog I will discuss the PCA3 test that may be helpful and prevent additional biopsies and additional psychological anxiety.

PCA3 Test

PCA3 is an acronym for Prostate CAncer gene 3. Prostate cells have PCA3 genes that are responsible for making this prostate cancer-specific protein. Prostate cancer cells produce higher levels of PCA3 than do healthy cells, and when the level of PCA3 protein is high, it leaks into the urine, where it can be measured. Unlike the PSA test, PCA3 is not affected by benign prostatic hyperplasia (enlarged prostate) or other noncancerous prostate conditions such as prostatitis.

To take the PCA3 test, you must first have a digital rectal examination (DRE), which stimulates the PCA3 to enter the urine. Then you must immediately provide a urine sample. Typically, it takes 1 to 2 weeks to obtain the results of the PCA3 test. For diagnostic purposes, the higher the PCA3 score, the more likely a man has prostate cancer. When the PCA3 score is used to help with treatment, the higher the score, the more aggressive the prostate cancer is likely to be.

The Food and Drug Administration approved the PCA3 test in 2012. Physicians can use the PCA3 score, in addition to DRE and PSA test, to help them make treatment decisions. For example, knowing a man’s PCA3 score can be helpful when:

• Men have a family history of prostate cancer
• Men have a positive biopsy, because their PCA3 score can provide additional information about how aggressive the cancer may be and therefore, be helpful in determining which treatment approach is best
• Men have an elevated PSA or a suspicious DRE and are considering a prostate biopsy
• Men have a negative result on their biopsy but the doctor is still uncertain about the presence of cancer
• Men have a positive result on their biopsy and they and their doctor want to better understand how aggressive the cancer is
• Men who have early, nonaggressive prostate cancer and have chosen active surveillance want to monitor any possible cancer progression

How effective is the PCA3 score in detecting prostate cancer? This question was addressed in a study involving 859 men who were scheduled to undergo a prostate biopsy. The authors found that use of the PCA3 test improved over-detection of low-grade prostate cancer and under-detection of high-grade cancer. Cost of the PCA3 test is about $450. The test is paid by most insurance companies including Medicare.

Bottom Line:  Prostate cancer is the most common cancer in men and the second most common cause of death in men.  The PSA test is a good screening test for men between the ages of 50 and 70.  However, there are false positive results with consequences of unnecessary prostate biopsies or may result in unnecessary repeat prostate biopsies.  The PCA3 test is helpful in identifying prostate cancer or helpful in reassuring a man that he doesn’t have prostate cancer and can avoid a repeat biopsy.  For more information, speak to your urologist.

Prostate Cancer prevention-Diet and Exercise

I am often asked what can patients do to prevent prostate cancer. Prostate cancer is the most common cancer in men, and is the second leading cause of death from all cancers in the U.S. following lunch cancer, which is the most deadly cancer in men. In fact, half of men in their 80s have prostate cancer. While this may sound scary, the good news is that prostate cancer is usually slow growing and if caught early on, can be treated and stopped.

The truth is that prostate cancer is regarded as one of the most curable cancers, if caught early.

Signs of prostate cancer

Let me start that from the onset, early prostate cancer may have NO signs and NO symptoms.

If prostate cancer is advanced or spread beyond the prostate gland the signs may include:

• Trouble urinating
• Decreased force in the stream of urine
• Blood in your urine or semen
• Pain in your lower back, hips or thighs
• Discomfort in the pelvic area
• Erectile dysfunction
• Elevated prostate-specific antigen test (PSA)

You may assume your urinary symptoms are a sign of a bladder infection or a kidney problem, but get it checked out. This can be especially true for younger men. While most cases of prostate cancer occur in men over 50, if you have difficulty starting a urine stream, have weak flow or have to go frequently, especially at night, get it checked out. It may not always be prostate cancer but does require an evaluation by a urologist.

Trouble urinating might simply indicate that your prostate is enlarged due to benign or non-cancerous causes. Having an enlarged prostate is not a sign of prostate cancer nor does it increase your risk of getting it.

Annual prostate screenings

Prostate cancer screenings work, especially for men ages 50 to 69. In recent years the formal recommendation for prostate screenings has changed. The U.S. Preventative Task Force on Health now says annual prostate screenings are not advised across the board, and are rather an item to be discussed and decided between a patient and doctor on an individual basis. If you have a family history, it’s a good idea to get checked regularly.

During a prostate screening, the doctor will test your PSA level, which is a simple blood test which measures a protein produced by your prostate gland. The higher the number, the greater chance you might have prostate cancer. (You should know that not all elevated PSAs point to cancer — some are caused by infections and even an enlarged prostate gland can elevate the PSA test.) Then, a physical exam is completed.

Preventing prostate cancer

Some risk factors for prostate cancer can’t be prevented, such as genetics and race. If you have a relative such as father, uncle, brother, or cousin with prostate cancer, then your risk is higher for prostate cancer. Also, African-American men have a higher incidence of prostate cancer and need to be screened at an earlier age.

While one in six men are diagnosed with prostate cancer at some time in their lives, that number increases to one in three for African Americans. Also, if you have a first degree relative who had prostate cancer — a dad or brother — your risk is doubled or tripled.

There are things you can do to prevent prostate cancer and cancer in general. Did you know that exercising three hours a week has been shown to greatly reduce your cancer risk overall? Eating well has similar results.

Live a healthy lifestyle: eat well, watch your weight and exercise frequently. By adopting a healthy lifestyle, you’ll decrease your risk for prostate cancer and other cancers as well.

 

Bottom Line: Prostate cancer is a common medical condition. Leading a health lifestyle with frequent exercise and a good diet can decrease your risk of developing prostate cancer.

Men Start Your Engines But First Check Under the Hood!

Men Start Your Engines But First Check Under the Hood!
This article appeared in the recent Baton Rouge Advocate on men’s health.

Celebrate Father’s Day with your health. Men need to let doctors look under the hood.

We have an attitude in our south Louisiana culture — if it ain’t broke, don’t fix it! In reality, men do more preventative maintenance on their cars and lawns than on their bodies. But, this attitude should never be applied to health.

Many men don’t receive checkups because they feel that they have a big “S” (for Superman) tattooed on their chests — but no one is Superman. On average, women live 5 to 7 years longer than men. That gap could close if men practiced preventive health as often as women. Fortunately, men’s attitude and behavior is slowly changing.

Not surprisingly, impotence drugs have lured men into the doctor’s office, which is half the battle and usually leads to a prostate screening. Over the years, public awareness campaigns, at-work health screenings and overall understanding of the male patient have aided in improving men’s health.

Before the 1990s, there were no male equivalents to the Pap test or mammogram. But now, the prostate-specific antigen (PSA) — the screening test for prostate cancer — is detecting problems early, giving men a myriad of treatment options and, more importantly, saving lives.
This means more time to enjoy their golden years, more time to walk their daughters down the aisle and more time to watch their grandchildren grow. Don’t wait for prostate cancer or other diseases to hit close to home; don’t wait for symptoms.
The only waiting should be done in your doctor’s waiting room.
Neil Baum
Professor of Clinical Urology At Tulane Medical School
New Orleans

Myths and Misinformation On Prostate Cancer

Prostate cancer is the second most common cancer in men, following lung cancer, with 250,000 new cases discovered each year. There are many areas of confusion about prostate cancer. Let me debunk a few of these myths.

Myth 1: Prostate cancer surgery will end your sex life and cause urine leakage.
Fact: Your surgeon may be able to spare the nerves that help trigger erections. Then you will probably be able to have an erection strong enough for sex again. But it may be a while. Recovery can take from 4 to 24 months, maybe longer. Younger men usually recover sooner.
If you still have trouble, ask your doctor about treatments for erectile dysfunction. Cialis, Levitra, and Viagra are common medications that can help. Your doctor will tell you if these are right for you.

Other prostate cancer treatments, such as radiation and hormone therapy, also can affect your sex life. Urine leakage may occur after surgery, but it’s usually temporary. Within a year, about 95% of men have as much bladder control as they did before surgery.

Myth 2: Only elderly men are at risk of prostate cancer.
Fact: Prostate cancer is rare for men under 40. If you are concerned, ask your doctor if you need to get tested earlier. Age isn’t the only factor. Others risk factors include:
Family history. If your father or brother had prostate cancer, your own risk doubles or triples. The more relatives you have with the disease, the greater your chances of getting it.
Race. If you are African-American, your risk of prostate cancer is higher than men of other races. Scientists do not yet know why.
You may want to discuss your risks with your doctor so you can decide together when you should be tested for prostate cancer with a screening PSA test and a digital rectal examination.

Myth 3: All prostate cancers must be treated.
Fact: You and your doctor may decide not to treat your prostate cancer. Reasons include:
Your cancer is at an early stage and is growing very slowly.
You are elderly or have other illnesses. Treatment for prostate cancer may not prolong your life and may complicate care for other health problems.
In such cases “active surveillance” may be an option to consider. This means that your doctor will regularly check you and order tests to make sure your cancer does not worsen. If your situation changes, you may decide to start treatment.

Myth 4: A high PSA score means you have prostate cancer.

Fact: Not necessarily. Your PSA could be high due to an enlarged prostate or inflammation in your prostate. The PSA score helps the doctor decide if you need more tests to check for prostate cancer. Also, your doctor is interested in your PSA score over time. Is it increasing, which could be a sign of a problem? Or, did it decrease after cancer treatment, which is great.

Myth 5: If you get prostate cancer, you will die of the disease.
Fact: You’re likely live to an old age or die of some other cause. That doesn’t mean checking for prostate cancer is not important. Most men with prostate cancer die with the cancer and not from it.

Bottom Line: I hope this article puts the perspective of prostate cancer back in its proper perspective. The diagnosis is common and help is available for most men with prostate cancer.