Dr. Neuner Discusses Prostate Cancer

Every year in the United States, 172,000 men are diagnosed with prostate cancer. Because prostate cancer often shows no symptoms, it is critical for men to talk to their primary care provider about getting screened. National guidelines suggest that men should begin getting screened at the age of 50. In this interview, Radiation Oncologist and Vice Chair of Radiation Oncology at GBMC, Geoffrey Neuner, MD, discusses screening, diagnosis, and treatment of prostate cancer.

While there aren’t many specific risk factors known for prostate cancer, some men are genetically predisposed to it. Men with a family history of prostate cancer should be proactive about talking to their doctor about their risk. African American men are also more likely to develop prostate cancer. One of the potential signs of prostate cancer is an elevated prostate specific antigen (PSA) level in the blood. PSA is a protein created produced by both cancerous and noncancerous cells in the prostate. Many noncancerous conditions can cause increased PSA levels, but it is an indicator that further testing may be needed.

If prostate cancer is diagnosed, treatment plans are truly tailored to the individual patient. Because of the large variation in the ways that prostate cancer can progress, physicians gather as much information as possible about the patient’s physical condition and his medical history. This entails additional PSA blood tests, a digital rectum exam performed by the physician, and a biopsy of the cancer cells. One of the things differentiates prostate cancer from other cancers is that treatment isn’t always needed after a diagnosis. If the cancer is slow growing and at an early stage, patients may be placed on “active surveillance.” This includes regular PSA blood tests and yearly exams to ensure the cancer isn’t spreading.

A new process that physicians use to predict the progression of the cancer is taking data obtained from other patients with similar genetic profiles. After a biopsy is completed, cancer cells can be genetically tested to determine specific characteristics for those cells. Although every patient is different, the progression of cancer in patients with similar cancer cells can be indicative of what will happen in the current patient. This information is used to create the most effective plan to treat the cancer.