When Dennis Hopper died of prostate cancer at age 74, my husband asked me, "Hey, I thought prostate cancer didn't kill men and it is slow growing." Well, he is right about it usually being slow growing, but prostate cancer is still the 2nd leading cause of cancer death in men. His question made me realize that there are some facts that everyone should know about prostate cancer.
Prostate cancer is very rare in men under age 40, and the incidence increases with age. African-American men are at higher risk, and Asian and Latin men are less likely than white guys to get it. We do not know why these ethnic differences occur. Family history is important, and men with an affected brother or father are twice as likely to get prostate cancer. Although genes are undoubtedly responsible, there are no genetic tests that can predict it. Some studies show obese men and men who eat large quantities of red meat and dairy products are more at risk. A vasectomy doesn't seem to matter, nor does exercise or prior prostatitis.
Prostate cancer grows slowly, and the PSA (prostate specific antigen) test or a digital rectal exam can screen for an enlarged prostate. The PSA test can be false positive for many reasons, and the only way to diagnose suspected prostate cancer is by a biopsy. The most important marker for a cancer in the prostate is the "Gleason" score. This grade (1-10) tells us how advanced or aggressive the cancer is. The pathologist can see if the cells are suspicious for atypical changes or are high-grade. The extent of the tumor determines the stage.
Once a cancer has been diagnosed, graded and staged, the confusing choices of treatment come into play. Because most prostate cancer occurs in older men and it is slow growing, many men choose "watchful waiting". By following PSA tests and ultrasounds, we can determine if the cancer is growing. For many men, nothing more needs to be done, because the cancer causes them no problems. For younger men or men with high Gleason scores, treatment is usually surgical removal of the prostate or radiation of the prostate gland. Radiotherapy can also occur with seed implantation of radioactive material. Hormone therapy or cryoablation is also used less often.
RIP, Dennis Hopper. I think I'll take a stroll down memory lane and rent "Easy Rider" again. I haven't seen it for 40 years!