Healthy Habits: Prostate Cancer Screening

Dr. Dall’Era’s clinical research is focused on active surveillance and clinical outcomes for men with prostate cancer. He investigates the role of active surveillance for low risk prostate cancer by assessing markers of progression, and outcomes for institutional cohorts. Dr. Dall’Era is a board certified Diplomate of the American Board of Urology and a member of the Society of Urologic oncology as well as Associate Professor for the Department of Urology at the University of California Davis School of Medicine. He has published extensively in the urologic literature while maintaining a robust clinical practice. I had a chance to interview him about prostate cancer.

1.    How prevalent is prostate cancer?
It is estimated that with PSA based screening, 1:5 US men will be diagnosed with prostate cancer

2.    How is it generally diagnosed?
Prostate cancer is diagnosed after a prostate biopsy is done for an elevated PSA or abnormal prostate exam

3.    What are some treatment options for those with prostate cancer?
Treatment options are based on estimating the risk the prostate cancer poses to the man's life. General treatment approaches for localized prostate cancer include active surveillance, prostatectomy (prostate removal), and radiation therapy (which comes in various forms). Metastatic prostate cancer is treated with hormonal therapy +/- chemotherapy with other options available as cancer progresses.  

4.    Why is it important to be educated about different options?
It is important to understand all options available, because one size does not fit all. Different options may be recommended based on how aggressive the cancer is and this is where a test such as the Oncotype Dx can help determine aggressiveness and assist in treatment decision making. Other considerations include patient age, health status, quality of life. Just as all patients are different, each prostate cancer is different and treatment decisions should be personalized based on thorough understanding of the disease and of all options available.  

5.    How can women be supportive of the men in their lives who have prostate cancer?
Spouses and partners are often critical to the decision making process. They can help during the data gathering phase for men to understand all of their treatment options. It is important for men and their partners to identify their priorities for treatment, balancing the desire for cancer eradication and maintaining quality of life. Shared decision making ensures that both patients and partners are on board with the treatment plan and can support each other throughout the process.