November 18, 2015

Men: This Movember, pay attention to your prostate.


It’s November — also known as Movember, a month dedicated to raising awareness and money for men’s health. The Movember Foundation is a global charity that works to improve men’s health, and one area of emphasis is prostate cancer.

The idea of Movember has gained popularity in recent years. Men grow a moutstache (a “mo!”) this month. Men who already have moustaches shave them off and spend the month re-growing.

Dr. Bob Matusik, a prostate cancer researcher at Vanderbilt, began Movember by having his beard shaved, for the sake of regrowing it, along with a moustache.

“The rules are that you are only to grow a mo,” Matusik said, but “I am breaking the rules by growing back a moustache and beard.”

Several other members of Vanderbilt’s department of urologic surgery will also celebrate Movember. (Moustache-growing contest, anyone?) Joining The Movember Foundation raises money for grants given to many organizations that work to improve men’s health.  Money raised by the Movember Foundation is donated to causes devoted to men’s health, such as the Prostate Cancer Foundation, The LIVESTRONG Foundation and the Prevention Institute.

Whether you grow a mo — or shave it off — Movember is a time for a prostate reality check. Ask your doctor:

Should I be worried about prostate cancer?

The prostate is a walnut-size gland located below a man’s bladder. Prostate cancer is the second most common type of cancer that men get (after skin cancer). It usually occurs in men older than 65. About 15 percent of American men will be diagnosed with prostate cancer sometime during their life, according to the National Cancer Institute (NCI).

Certain men are more likely to get prostate cancer than others. African-American men, and any man with a family history of prostate cancer, especially when it’s diagnosed before age 50, have the greatest risk of prostate cancer. These men should talk to their doctors about the right time to be screened (checked) for prostate cancer.

Other things that put you at high risk for prostate cancer: being overweight, and, according to some studies, eating a lot of meat that’s been cooked at extremely high temperatures.

Prostate cancer is highly curable when it’s detected in its early stages.

What are the symptoms of prostate cancer?

Symptoms of prostate cancer can include a weak flow of urine; frequent urination; having sudden urges to urinate; difficulty starting to urinate, or completely emptying the bladder; blood in the urine or semen; pain in the back, pelvis or hips that doesn’t fade away; shortness of breath, fatigue; rapid heartbeat; dizziness; or pale skin (due to anemia, a low level of iron in the blood).

Other illnesses can cause these symptoms, including having an enlarged prostate that is not cancerous, so it’s important to discuss them with your doctor to get a diagnosis.

Men with prostate cancer in its earliest stages sometimes feel no symptoms at all.

Should I be screened for prostate cancer?

Men 50 years old or older should be checked for prostate cancer once every year. But men with a family history of prostate cancer should be checked every year starting at age 40.

Screening includes two types of checks: the digital rectal exam and a blood test for prostate specific antigen (PSA) level.

Should I be screened with the PSA test?

For years, the PSA test has been the standard way to screen men for prostate cancer, so men have been urged to have their PSA levels checked every year after their 50th birthday. It’s still a very helpful diagnostic tool, and men at high risk of having prostate cancer should start getting yearly screenings starting at age 40 or 45, depending on their doctor’s recommendation.

But today, more is known about the pros and cons of PSA screening. The biggest disadvantage is that the test might incorrectly indicate that you have cancer when you don’t, leading to a biopsy, which carries some small risks. Only 25 percent of men with a high PSA level who have biopsies are actually found to have prostate cancer.

Also, PSA levels can indicate small tumors that aren’t causing any problems. Discovering such a tumor may lead to overtreatment — treatment that’s not necessary and may cause side effects.

A recent study published in the Journal of American Medical Association notes a decline in the number of diagnoses of early stage prostate cancers and researchers suggested a decline in PSA testing is to blame. Vanderbilt’s Dr. David Penson, who wrote an editorial accompanying the journal article, told the New York Times that while PSA is an imperfect test, doctors can be “using it smarter.”

You should talk to your doctor about when it’s time for you to have your PSA level checked or if you should have it checked at all.


Will you do mo for your health this Movember? Visit the Movember Foundation for events and information.
You can learn more about the treatments offered at the Vanderbilt University Medical Center, here
David Penson, M.D., M.P.H., is the Paul V. Hamilton, M.D., and Virginia E. Howd Chair of Urologic Oncology, Professor and Chair of the Department of Urology and Professor of Medicine and Health Policy at Vanderbilt University Medical Center. His research is focused on the comparative effectiveness of treatments for localized prostate cancer.