I would like to share a bit of insight into what our more mature male friends should be aware of regarding prostate cancer, and it is not about the cancer itself. If you ask most men of an age what health issues they fear, chances are that prostate cancer will be high on the list. One in seven men will be diagnosed with prostate cancer in their lifetimes, but only one in 39 actually will die of this disease. Even so about 80% of men who reach age 80 will have cancer cells within their prostate.
For men who may have a family history of prostate cancer or who are getting on in years, it is important to be vigilant. A patient may have signs of possible prostate cancer from other screenings such as MRIs, and this usually results in a referral to a urologist. If you or an older loved one comes to this fork in the road, listen carefully to what test is proposed to see if there is cause to truly be addressing the potential for cancer…or is it just a suspicion or a possibility. If the urologist talks of a random transrectal biopsy, that means they are planning to take a number of samples from the prostate. The random means that they don’t have a specific locale to investigate, so they will check around to see if there is anything to cause concern. They may take a dozen or so samples and test for cancerous cells.
The tansrectal part is pretty clear as their point of access to the prostate, but this also is where other more immediate problems can arise. In about one in twenty of these procedures, an infection results. Since this infection will now be inside the patient, there are no signs before the fever spikes, and since it is inside, it can quickly turn into a full-blown sepsis. As many as one in three patients will die from a “severe sepsis,” so this is not a sequence of steps to be taken lightly.
And there are alternatives. Ask your physician about the utility of a color Dopplar ultrasound or an MRI to check for signs of prostate cancer. These procedures can be repeated over time to be on top of things. There also are alternative biopsy procedures such as a transperineal approach which has an infection rate of only 0.5 percent. There are also MRI-guided biopsy systems which can be directed specifically at any suspicious tissue first identified by non-invasive imaging. And by the way, random biopsies do not have a stellar diagnostic track record either; they miss up to 30% of actual tumors.
So, it is important to be watchful in all cases, but it also is important to listen carefully to what is recommended by your physician or the specialist to whom you have been referred. And never hesitate to ask for a second opinion.
Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia.