Commentary by Clinton D. Bahler, MD, MS, IU Health Physicians
Exciting advances in the management of prostate cancer are making it possible for doctors to provide more personalized treatment to men diagnosed with the disease. While prostate cancer screening, which includes the prostate specific antigen (PSA) blood test and digital rectal exam, detects many cancers, screening is not always able to tell the difference between slow-growing tumors, which are common, and more aggressive forms of the disease that can lead to symptoms and death. This has led to overtreatment of prostate cancer in some cases.
Now, through a combination of MRI-guided biopsy and genetic testing, urologists are able to more accurately determine the type of tumor and whether a “watchful waiting” approach is advisable given the presence of slow-growing tumors. Genetic testing also can predict whether the cancer is likely to spread beyond the prostate. Both of these advancements help prevent overtreatment of those prostate cancers that are unlikely to cause death.
For men with more aggressive tumors that are localized within the prostate, a new minimally invasive method for treating prostate cancer has been recently approved by the Food and Drug Administration. Pioneered at Indiana University School of Medicine for the localized treatment of prostate cancer, the technique uses high-intensity, focused ultrasound to destroy cancerous tissue with fewer side effects, including lower risk of incontinence and sexual dysfunction, than traditional prostate surgery.
Men between the ages of 50 and 70 should discuss the risks and benefits of PSA screening with their doctor. Those at greater risk of developing prostate cancer, which include African-Americans and men with a family history of the disease, should talk with their primary care doctor about when PSA screening should begin and how often the test should be completed.
Clinton D. Bahler, MD, MS, specializes in minimally invasive approaches to prostate and kidney cancer. He is a guest columnist located at IU Health Physicians at IU Health North Hospital and can be reached by calling the office at 317.688.5504. For more health information, subscribe to Strength in You at iuhealth.org/StrengthInYou.